摘要
目的探讨口服阿替洛尔对比口服普萘洛尔治疗婴幼儿血管瘤在疗效、安全性及复发率方面的差异,为临床提供循证医学依据及参考。方法全面搜索2008年1月至2021年6月英文数据库Web of Science、PubMed、Cochrane Library、Embase、美国国立医学图书馆临床试验注册平台(https://clinicaltrials.gov)和中文数据库中国知网(CNKI)、中国生物医学文献服务系统、维普、万方数据中收录的相关文献,按照纳入及排除标准,筛选出关于口服阿替洛尔对比口服普萘洛尔治疗婴幼儿血管瘤的随机对照试验,进行meta分析。结局指标为治疗有效率、不良反应发生率和复发率。采用RevMan 5.3软件进行meta分析,并对结果进行敏感性分析,采用Stata 16软件对主要结局指标进行发表性偏倚检测(Egger’s检验)。结果最终纳入随机对照试验文献5篇。meta分析结果显示:口服阿替洛尔与口服普萘洛尔相比,治疗婴幼儿血管瘤有效率的差异无统计学意义(RR=0.93,95%CI 0.84~1.02,P=0.110);总体不良反应发生率差异有统计学意义(RR=0.78,95%CI 0.61~0.99,P=0.040),其中支气管相关、中枢神经系统等β_(2)受体阻滞剂相关不良反应发生率差异有统计学意义(RR=0.55,95%CI 0.40~0.76,P<0.001),阿替洛尔组低于普萘洛尔组;复发率差异有统计学意义(RR=0.57,95%CI 0.39~0.84,P=0.005),阿替洛尔组低于普萘洛尔组。敏感性分析显示,排除任何1项研究后的结果与前述分析结果相比变化较小,所得结论不变,提示meta分析结果稳定可靠。Egger’s检验显示,P=0.502,提示无明显发表偏倚。结论在治疗婴幼儿血管瘤方面,口服阿替洛尔对比口服普萘洛尔,疗效相当,前者总体不良反应更少(并可降低支气管相关、中枢神经系统不良反应),复发率更低。
Objective To explore the difference of the efficacy,safety and recurrence rate of oral atenolol compared with oral propranolol in the treatment of infantile hemangioma,so as to provide evidence-based medicine basis and reference for clinic.Methods A comprehensive search was conducted on the English databases Web of Science,PubMed,Cochrane Library,Embase,U.S.National Library of Medicine Clinical Trials Registry Platform(https://clinicaltrials.gov)and on the Chinese databases CNKI,CBM,VIP,Wanfang Data from January 2008 to June 2021,according to our defined inclusion and exclusion criteria,randomized controlled trials of oral atenolol versus oral propranolol in the treatment of infantile hemangioma were selected for performing meta-analysis,and the outcome indicators were treatment efficiency,incidence of adverse reactions,and recurrence rate.Meta-analysis was performed by using RevMan 5.3 software,and sensitivity analysis of the result was performed,and the main outcome indicators were tested for publication bias(Egger’s test)by using Stata 16 software.Results Finally,5 randomized controlled trials references were included.Our meta-analysis showed that there was no significant difference in the effective rate between oral atenolol and oral propranolol in the treatment of infantile hemangioma(RR=0.93,95%CI 0.84-1.02,P=0.110).There was a statistically significant difference in the overall incidence of adverse reactions(RR=0.78,95%CI 0.61-0.99,P=0.040),bronch-related and central nervous system related to β_(2)-blockade(RR=0.55,95%CI 0.40-0.76,P<0.001)adverse reactions,which were lower in the atenolol group than in the propranolol group;there was a statistically significant difference in the recurrence rate(RR=0.57,95%CI 0.39-0.84,P=0.005),which was lower in the atenolol group than in the propranolol group.The sensitivity analysis showed that the result after the exclusion of any 1 study were less variable compared with the result of the previous analysis,and the conclusion obtained were unchanged,suggesting that th
作者
郑健敏
朱智胜
王朝阳
朱世泽
Zheng Jianmin;Zhu Zhisheng;Wang Chaoyang;Zhu Shize(Plastic Surgery Department,the Second Affiliated Hospital of Fujian Medical University,Quanzhou 362000,China)
出处
《中华整形外科杂志》
CSCD
2022年第3期275-283,共9页
Chinese Journal of Plastic Surgery
