预防性药物预防早产儿视网膜病变的有效性和安全性:随机对照试验的系统评价和荟萃分析。

IF 2 Q2 OPHTHALMOLOGY BMJ Open Ophthalmology Pub Date : 2024-12-25 DOI:10.1136/bmjophth-2024-001910
Waleed T Batais, Nada O Taher, Abeer K Alhindi, Abdullah A Ghaddaf, Anas Alamoudi, Sarah A Al-Ghamdi, Jumanah J Homsi, Hashem S Almarzouki, Mansour A Qurashi
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引用次数: 0

摘要

目的:早产儿视网膜病变(ROP)是低出生体重早产儿可预防的儿童失明的主要原因。包括维生素A、心得安和脂类在内的预防药物在降低ROP发生率方面的有效性和安全性尚不清楚。本系统综述和荟萃分析评估了这些药物预防ROP的有效性和安全性。方法与分析:系统检索Embase、MEDLINE和CENTRAL数据库。纳入了8项随机对照试验,涉及1101名早产儿。我们评估了任何阶段ROP的发生率、严重ROP、不良事件和死亡率。对每种预防药物进行亚组分析。使用反方差加权法合并数据,并以95% CI的风险比(RRs)报告。结果:与安慰剂组相比,干预组在任何阶段ROP发生率均未显著降低(RR=0.83;95% CI= (0.69 ~ 1.00);p = 0.05;²= 0%)。脂质显著降低严重ROP发生率(RR=0.48;95% CI= (0.28 ~ 0.80);p=0.005),维生素A (RR=1.14;95% CI= (0.51 ~ 2.54);p=0.75)和心得安(RR=0.69;95% CI= (0.29 ~ 1.65);P =0.41)。两组不良事件发生率差异无统计学意义(RR=0.83;95% CI= (0.59 ~ 1.17);p=0.28)或死亡率(RR=0.93;95% CI= (0.67 ~ 1.30);P =0.68)。结论:脂类药物在降低早产儿严重ROP方面有希望,而维生素A和心得安无效。需要进一步的研究来证实这些发现,并探索脂质在临床实践中的潜在作用。
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Efficacy and Safety of Prophylactic Agents in Prevention of Retinopathy of Prematurity: A Systematic Review and Meta-analysis of Randomised Controlled rials.

Objective: Retinopathy of prematurity (ROP) is a leading cause of preventable childhood blindness in preterm infants with low birth weight. The efficacy and safety of prophylactic agents, including vitamin A, propranolol and lipids, in reducing ROP incidence remain unclear. This systematic review and meta-analysis evaluated the effectiveness and safety of these agents in preventing ROP.

Methods and analysis: A systematic search was conducted in Embase, MEDLINE and CENTRAL databases. Eight randomised controlled trials involving 1101 preterm infants were included. We assessed the incidence of ROP at any stage, severe ROP, adverse events and mortality. Subgroup analyses were performed for each prophylactic agent. Data were pooled using the inverse variance weighting method and reported as risk ratios (RRs) with 95% CI.

Results: No significant reduction in ROP incidence at any stage was found in the intervention groups compared with placebo (RR=0.83; 95% CI= (0.69 to 1.00); p=0.05; I²=0%). Lipids significantly reduced severe ROP incidence (RR=0.48; 95% CI= (0.28 to 0.80); p=0.005), while vitamin A (RR=1.14; 95% CI= (0.51 to 2.54); p=0.75) and propranolol (RR=0.69; 95% CI= (0.29 to 1.65); p=0.41) did not. There were no significant differences in adverse events (RR=0.83; 95% CI= (0.59 to 1.17); p=0.28) or mortality (RR=0.93; 95% CI= (0.67 to 1.30); p=0.68) across all groups.

Conclusion: Lipids show promise in reducing severe ROP in preterm infants, while vitamin A and propranolol were not effective. Further research is needed to confirm these findings and explore the potential role of lipids in clinical practice.

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来源期刊
BMJ Open Ophthalmology
BMJ Open Ophthalmology OPHTHALMOLOGY-
CiteScore
3.40
自引率
4.20%
发文量
104
审稿时长
20 weeks
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