Wang Ting, Jiang Ruoan, Yao Yingsha, Xu Ting, Li Na
Department of Obstetrics and Gynecology, Women's Hospital Zhejiang University School of Medicine, Hangzhou, China.
Zhejiang Provincial Clinical Research Center for Obstetrics and Gynecology, Hangzhou, China.
Hypertens Pregnancy. 2024 Dec;43(1):2329068. doi: 10.1080/10641955.2024.2329068. Epub 2024 Mar 15.
Preeclampsia (PE) is a pregnancy disorder that represents a major cause of maternal and perinatal morbidity and mortality.
This network meta-analysis was registered with PROSPERO. We searched the PubMed, ClinicalTrials.gov. and Embase databases for studies published from inception to the 31 of March 2023. RevMan5.3 software provided by the Cochrane Collaboration was used for direct meta-analysis (DMA) statistical analysis. Funnel maps, network meta-analysis (NMA), the surface under the cumulative ranking curve (SUCRA) to rank the different interventions and publication bias were generated by STATA 17.0 software.
We included eight randomized controlled trials (RCTs) involving a total of 1192 women with PE; two studies were of high quality and six were of moderate quality. Eight interventions were addressed in the NMA. In the DMA, we found that blood pressure in the Ketanserin group were significantly higher than those in the Nicardipine group. NMA showed that blood pressure in the Dihydralazine group was significantly higher than that in the Methyldopa, Labetalol, Nicardipine and Diltiazem groups. And the blood pressure in the Labetalol group was significantly lower than that in the Nicardipine group. SUCRA values showed that Diltiazem was more effective in lowering blood pressure than other drugs looked at in this study.
According to the eight RCTs included in this study, Diltiazem was the most effective in reducing blood pressure in PE patients; Labetalol and Nicardipine also had good effects. Diltiazem is preferred for the treatment of patients with severe PE and high blood pressure.
子痫前期（PE）是一种妊娠疾病，是孕产妇和围产儿发病及死亡的主要原因。
该网络荟萃分析已在国际前瞻性系统评价注册库（PROSPERO）登记。我们检索了PubMed、ClinicalTrials.gov和Embase数据库，以查找从数据库建库至2023年3月31日发表的研究。使用Cochrane协作网提供的RevMan5.3软件进行直接荟萃分析（DMA）统计分析。通过STATA 17.0软件生成漏斗图、网络荟萃分析（NMA）、累积排序曲线下面积（SUCRA）以对不同干预措施进行排序以及发表偏倚分析。
我们纳入了八项随机对照试验（RCT），共涉及1192例PE女性患者；两项研究质量高，六项研究质量中等。NMA涉及八项干预措施。在DMA中，我们发现酮色林组的血压显著高于尼卡地平组。NMA显示，肼屈嗪组的血压显著高于甲基多巴、拉贝洛尔、尼卡地平和地尔硫䓬组。拉贝洛尔组的血压显著低于尼卡地平组。SUCRA值显示，在本研究中，地尔硫䓬在降低血压方面比其他药物更有效。
根据本研究纳入的八项RCT，地尔硫䓬在降低PE患者血压方面最有效；拉贝洛尔和尼卡地平也有良好效果。地尔硫䓬是治疗重度PE和高血压患者的首选药物。
