摘要
目的系统评价羟氯喹（HCQ）治疗妊娠合并红斑狼疮（LE）的疗效及安全性。方法计算机检索Cochrane图书馆、Medline、EMBase、PubMed、中国期刊全文数据库（CNKI）、中国生物医学文献数据库（CMB）、雏普信息资源系统（VIP）、万方数字化期刊全文数据库，查找以HCQ治疗妊娠合并LE的随机对照试验（RCT）或对照试验。对纳入的实验进行质量评价，并使用RevMan5．1软件进行Meta分析。结果共纳入6项研究，包括278例患者（观察组140例，对照组138例）。Meta分析结果显示：HCQ治疗可减少狼疮活动（OR=0．24，95％CI：0．11～0．54，P=0．0005）；两组妊娠初期系统性红斑狼疮疾病活动（SLE—DAI），差异无统计学意义（MD=-0．14，95％CI：-1．07～0．79，P=0．7700）；观察组在妊娠中期及末期SLEDAI明显降低（MD=-2．24，95％CI：-3．26～1．22，P〈0．01；MD=-2．59，95％CI：-3．70～1．48，P〈0．01），不良妊娠结局发生率降低（OR=0．41，95％CI：0．22～0．75，P=0．0040），同时新生儿体质量高于对照组（MD=314．64，95％CI：137．88～491．40，P=0．0005）；新生儿1min和5min Apgar评分两组无差异（MD=0．23，95％CI：-0．12～0．58，P=0．2100；MD=0．14，95％CI：-0．14～0．41，P=0．3200）。结论HCQ治疗妊娠合并LE在减少狼疮活动，降低妊娠中、末期SLEDAI及改善妊娠结局方面有积极作用，同时不增加不良胎儿结局的发生风险。
Objective To systematically evaluate the efficacy and safety of hydroxychloroquine（HCQ） in the treatment of pregnancy complicating lupus erythematosus （LE）. Methods The databases of Cochrane library, Medline, EMBase, PubMed, CNKI,Chinese biomedical literature database（CBM）, VIP, WangFang digital journals were retrieved for finding randomized controlled trials （RCTs） or comparative study of HCQ in the treatment of pregnancy complicating LE. The RevMan 5.1 statistical software was employed to conduct systematic review. Results Six RCTs were included,involving 278 patients （140 cases as the observation group and 138 cases as the control group）. The meta analysis results suggested that the observation group had lower lupus activity rate（OR= 0. 24,95% CI： 0. 11- 0. 54, P=0. 000 5） and had lower systemic lupus erythematosus disease activity index （SLEDAI） in the mid and late pregnancy（MD=-2.24,95%CI：-3.9.6-1.22,P〈0.01;MD=-2.59,95% CI：-3.70-1.48, P〈0.01） ;the two groups were not significantly different in the early pregnancy in SLEDAI（MD=-0.14,95 %CI：-1.07-0.79, P=0.77） ;The two groups were significantly different in the incidence rate of adverse pregnancy outcomes（OR= 0.41,95%CI： 0.22-0.75,P= 0. 004 0） ;the fetal body mass in the observation group was higher than that of the control group（MD= 314.64, 95%CI： 137. 88- 491. 40, P = 0. 000 5）; there was no significant differences in neonatal 1 min Apgar score （MID = 0. 23, 95;CI：-0.12-0.58,P=0. 210 0）and neonatal 5 min Apgar score（MD=0.14,95%CI：-0.14-0.41,P=0. 320 0）. Conclusion HCQ could decrease the rates of lupus activity and the risk of adverse pregnancy outcomes,moreover decreases SLEDAI risk in the mid and late pregnancy in pregnant patient with LE,without increasing the risk of adverse fetal outcomes.
出处
《重庆医学》
CAS
北大核心
2016年第13期1803-1806,共4页
Chongqing medicine
基金
国家自然科学基金面上资助项目(81573027)
重庆市自然科学基金计划项目(cstc2011jjA10039)
关键词
红斑狼疮
羟氯喹
妊娠
系统评价
lupus erythematosus
hydroxychloroquine
pregnant
systematic review
