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目的评价神经节苷脂治疗新生儿缺氧缺血性脑病(HIE)的有效性及安全性。方法计算机检索PubMed、EMBASE、Cochrane图书馆、中国生物医学文献数据库、中国期刊全文数据库、中文科技期刊全文数据库、万方数字化全文期刊数据库,检索时间均从建库至2010年12月。纳入有关神经节苷脂治疗HIE的随机对照试验,对其进行质量评价,采用RevMan5.0软件进行统计学处理。结果共纳入10篇,849例患儿,Meta分析结果显示:与常规治疗组相比,神经节苷脂组在远期神经系统后遗症,头颅CT异常的发生率,7 d、10～14 d、28 d神经行为评分方面差异均有统计学意义,其RR(95%CI)分别为0.35(0.15,0.82)、0.56(0.39,0.78)、3.01(2.22,3.81)、2.51(2.19,2.83)、2.81(2.26,3.36)。在其病死率方面差异无统计学意义,其RR(95%CI)为0.59(0.14,2.39)。结论神经节苷脂治疗HIE可以降低远期神经系统后遗症,提高神经行为评分,降低头颅CT异常的发生率。
Objective To evaluate the efficacy and safety of gangliosides in the treatment of neonatal hypoxic-ischemic encephalopathy (HIE). Methods PubMed, EMBASE, Cochrane Library, China Biomedical Literature Database, Chinese Journal Full-text Database, Chinese Science and Technology Journal Full-text Database, Wanfang Digitized Full-text Journal Database were searched by computer. Randomized controlled trials of ganglioside for the treatment of HIE were included in this study. The quality of the study was evaluated and the data were analyzed by RevMan 5.0 software. Results A total of 10 articles including 849 cases were included in the study. The results of Meta analysis showed that the incidence of long-term neurological sequela and head CT abnormalities in the ganglioside group was significantly higher than that in the conventional treatment group at 7 d, 10 to 14 d, There were significant differences in neurobehavioral scores between the two groups (P> 0.05). The RR of 95% CI was 0.35 (0.15,0.82), 0.56 (0.39,0.78), 3.01 (2.22,3.81), 2.51 (2.19,2.83) 2.81 (2.26,3.36). There was no significant difference in the case fatality rate, and RR (95% CI) was 0.59 (0.14, 2.39). Conclusion Ganglioside treatment of HIE can reduce long-term neurological sequelae, improve neurobehavioral scores, and reduce the incidence of CT abnormalities.