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目的系统评价磷酸肌酸钠(CPS)治疗新生儿窒息后心肌损伤的疗效。方法计算机检索中英文数据库,搜集关于磷酸肌酸钠辅助治疗新生儿窒息合并心肌损伤的随机对照试验(RCT),检索从建库至2016年1月已发表的中英文文献。筛选和评价纳入的文献,采用Rev Man 5.3对数据进行Meta分析。结果共纳入21项随机对照研究,合计1 574例新生儿窒息后心肌损伤的患儿。Meta分析结果显示,联用CPS组患儿总有效率高于常规治疗组[OR=4.27,95%CI(3.05,6.00)],联用CPS组心肌损伤指标与常规治疗组相比均有下降。CK[WMD=-192.04,95%CI(-263.02,-121.06)]、CK-MB[WMD=-16.62,95%CI(-21.18,-12.05)]、HBDH[WMD=-61.57,95%CI(-81.29,-41.85)]、LDH[WMD=-163.11,95%CI(-202.06,-124.15)]、c Tn I[WMD=-0.26,95%CI(-0.37,-0.14)]、AST[WMD=-8.87,95%CI(-11.77,-5.97)]联用磷酸肌酸钠治疗心肌损伤的效果明显优于常规治疗组。结论当前证据表明:CPS治疗新生儿窒息后心肌损伤具有一定疗效,联用磷酸肌酸钠能降低新生儿窒息后导致心肌损伤的相关指标。
Objective To evaluate the efficacy of sodium phosphate phoshate (CPS) in the treatment of neonatal asphyxia myocardial injury. Methods The Chinese and English databases were searched by computer, and randomized controlled trials (RCTs) on the adjuvant treatment of neonatal asphyxia with myocardial injury by sodium creatine phosphate were collected and the published articles in Chinese and English from the database to January 2016 were searched. The included literature was screened and evaluated, and Meta-analysis of the data was performed using Rev Man 5.3. Results A total of 21 RCTs were enrolled in this study. A total of 1 574 infants with post-asphyxial myocardial injury were enrolled. The results of Meta-analysis showed that the total effective rate of CPS group was higher than that of routine treatment group [OR = 4.27,95% CI (3.05,6.00)]. Compared with CPS group, myocardial injury index decreased . CK [WMD = -16.62, 95% CI (-21.18, -12.05)], HBDH [WMD = -61.57, 95% CI (-263.02, -121.06) (-81.29, -41.85)], LDH [WMD = -163.11,95% CI (-202.06, -124.15)], cTn I [WMD = -0.26,95% CI (-0.37, -0.14)], AST [WMD = -8.87,95% CI (-11.77, -5.97)] combined with sodium creatine phosphate treatment of myocardial injury was significantly better than the conventional treatment group. Conclusions The current evidence suggests that CPS may have some therapeutic effect on myocardial injury after neonatal asphyxia, and the combination of sodium creatine phosphate can reduce the index of myocardial damage caused by neonatal asphyxia.