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12 小时与 24 小时硫酸镁治疗子痫前期和子痫患者的疗效和安全性：系统评价和荟萃分析。

Efficacy and safety of 12-hour versus 24-hour magnesium sulfate in management of patients with pre-eclampsia and eclampsia: a systematic review and meta-analysis.

机构信息

Faculty of Medicine, Benha University, Benha, Egypt.

Faculty of Medicine, Aleppo University, Aleppo, Syria.

出版信息

BMC Womens Health. 2024 Jul 25;24(1):421. doi: 10.1186/s12905-024-03271-0.

DOI:10.1186/s12905-024-03271-0
PMID:39054515
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11270768/
Abstract

INTRODUCTION

Magnesium sulfate is the most utilized anticonvulsant for treating patients with eclampsia and pre-eclampsia. The purpose of this study is to determine whether the 12-h regimen of magnesium sulfate outweighs the 24-h regimen in both efficacy and safety in the management of patients with mild or severe pre-eclampsia and eclampsia.

METHODS

We searched six electronic databases: PubMed, Scopus, Web of Science, Cochrane Library, Ovid, and Google Scholar. This search was conducted to yield any studies that were published until 15 January 2023. We did the statistical analysis plan by Review Manager Software version 5.4.

RESULTS

We included 13 randomized control trials with 2813 patients in this systematic review. Our meta-analysis revealed that there were no statistically significant differences between the 12-h regimen of the magnesium sulfate group and the 24-h regimen of the magnesium sulfate group in our outcome of interest: occurrence of seizure (RD: -0.00, 95% CI [-0.01, 0.00], P = 0.56), diminished deep tendon reflexes (RD: -0.00, 95% CI [-0.01, 0.01], P = 0.80), respiratory depression (RD: -0.00, 95% CI [-0.02, 0.01], P = 0.57), and pulmonary edema (RD: -0.00, 95% CI [-0.01, 0.01], P = 0.85).

CONCLUSION

Our study showed no statistically significant difference in effectiveness and toxicity risk between the 12-h and 24-h regimens.

摘要

简介

硫酸镁是治疗子痫前期和子痫患者最常用的抗惊厥药物。本研究旨在确定在轻度或重度子痫前期和子痫的患者管理中，硫酸镁 12 小时疗程在疗效和安全性方面是否优于 24 小时疗程。

方法

我们检索了六个电子数据库：PubMed、Scopus、Web of Science、Cochrane Library、Ovid 和 Google Scholar。此次搜索旨在获取截至 2023 年 1 月 15 日发表的任何研究。我们使用 Review Manager Software 版本 5.4 制定了统计分析计划。

结果

我们在这项系统评价中纳入了 13 项随机对照试验，共有 2813 名患者。我们的荟萃分析显示，在我们感兴趣的结局中，硫酸镁 12 小时疗程组和硫酸镁 24 小时疗程组之间没有统计学上的显著差异：发作的发生（RD：-0.00，95%CI[-0.01，0.00]，P=0.56）、深部腱反射减弱（RD：-0.00，95%CI[-0.01，0.01]，P=0.80）、呼吸抑制（RD：-0.00，95%CI[-0.02，0.01]，P=0.57）和肺水肿（RD：-0.00，95%CI[-0.01，0.01]，P=0.85）。

结论

我们的研究表明，12 小时和 24 小时疗程在疗效和毒性风险方面没有统计学上的显著差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b7db/11270768/a7ecedf64a67/12905_2024_3271_Fig8_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b7db/11270768/cf8b80f71cc0/12905_2024_3271_Fig1_HTML.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b7db/11270768/a7ecedf64a67/12905_2024_3271_Fig8_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b7db/11270768/cf8b80f71cc0/12905_2024_3271_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b7db/11270768/025ae22cdf85/12905_2024_3271_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b7db/11270768/8287d9df56a8/12905_2024_3271_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b7db/11270768/bd3092347de2/12905_2024_3271_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b7db/11270768/31b98c64bd88/12905_2024_3271_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b7db/11270768/f4b2b3bdac29/12905_2024_3271_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b7db/11270768/310b5f96c856/12905_2024_3271_Fig7_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b7db/11270768/a7ecedf64a67/12905_2024_3271_Fig8_HTML.jpg

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本文引用的文献

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Eclampsia: A Critical Pregnancy Complication Demanding Enhanced Maternal Care: A Review.子痫：一种需要加强孕产妇护理的严重妊娠并发症：综述。
Med Sci Monit. 2023 Jul 7;29:e939919. doi: 10.12659/MSM.939919.
2
Comparison of Zuspan regimen and its 12-hour modification in women with severe pre-eclampsia and eclampsia in two hospitals in Abeokuta.在阿贝奥库塔的两家医院中，比较严重子痫前期和子痫妇女的 Zuspan 方案及其 12 小时改良方案。
Pregnancy Hypertens. 2023 Jun;32:22-27. doi: 10.1016/j.preghy.2023.03.001. Epub 2023 Mar 12.
3
A novel 12-hour versus 24-hour magnesium sulfate regimen in the management of eclampsia and preeclampsia in Ghana (MOPEP Study): A randomized controlled trial.
加纳子痫和子痫前期管理中新型12小时与24小时硫酸镁治疗方案（MOPEP研究）：一项随机对照试验。
Int J Gynaecol Obstet. 2022 Nov;159(2):495-504. doi: 10.1002/ijgo.14181. Epub 2022 Apr 6.
4
Preeclampsia and eclampsia: the conceptual evolution of a syndrome.子痫前期与子痫：综合征概念的演变。
Am J Obstet Gynecol. 2022 Feb;226(2S):S786-S803. doi: 10.1016/j.ajog.2021.12.001.
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Duration of postpartum magnesium sulfate for seizure prophylaxis in women with preeclampsia: a systematic review and meta-analysis.子痫前期产妇预防性应用硫酸镁的持续时间：系统评价和荟萃分析。
J Matern Fetal Neonatal Med. 2022 Dec;35(25):7188-7193. doi: 10.1080/14767058.2021.1946505. Epub 2021 Jun 30.
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The PRISMA 2020 statement: an updated guideline for reporting systematic reviews.PRISMA 2020 声明：系统评价报告的更新指南。
BMJ. 2021 Mar 29;372:n71. doi: 10.1136/bmj.n71.
7
Shortened postpartum magnesium sulfate treatment vs traditional 24h for severe preeclampsia: a systematic review and meta-analysis of randomized trials.缩短重度子痫前期产后硫酸镁治疗时间（24 小时）与传统 24 小时治疗的比较：一项随机试验的系统评价和荟萃分析。
Hypertens Pregnancy. 2020 May;39(2):186-195. doi: 10.1080/10641955.2020.1753067. Epub 2020 Apr 26.
8
Intravenous magnesium sulfate in the management of severe pre-eclampsia: A randomized study of 12-hour versus 24-hour maintenance dose.静脉注射硫酸镁治疗重度子痫前期：12 小时与 24 小时维持剂量的随机研究。
Int J Gynaecol Obstet. 2020 Apr;149(1):37-42. doi: 10.1002/ijgo.13082. Epub 2020 Jan 8.
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Maternal outcomes after 12hours and 24hours of magnesium sulfate therapy for eclampsia.硫酸镁治疗子痫12小时和24小时后的产妇结局。
Int J Gynaecol Obstet. 2016 Jan;132(1):68-71. doi: 10.1016/j.ijgo.2015.06.056. Epub 2015 Oct 14.
10
Alternative regimens of magnesium sulfate for treatment of preeclampsia and eclampsia: a systematic review of non-randomized studies.硫酸镁治疗子痫前期和子痫的替代方案：非随机研究的系统评价
Acta Obstet Gynecol Scand. 2016 Feb;95(2):144-56. doi: 10.1111/aogs.12807. Epub 2015 Nov 8.