[1]许雅娟,孙宗宗,翟闪闪,等.低分子肝素防治妊娠期高血压疾病的效果和安全性[J].郑州大学学报(医学版),2019,(04):587-592.[doi:10.13705/j.issn.1671-6825.2018.10.131]
 XU Yajuan,SUN Zongzong,ZHAI Shanshan,et al.Low molecular weight heparin for the prevention and treatment of hypertensive disorders complicating pregnancy:a meta-analysis[J].JOURNAL OF ZHENGZHOU UNIVERSITY(MEDICAL SCIENCES),2019,(04):587-592.[doi:10.13705/j.issn.1671-6825.2018.10.131]
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低分子肝素防治妊娠期高血压疾病的效果和安全性()
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《郑州大学学报(医学版)》[ISSN:1671-6825/CN:41-1340/R]

卷:
期数:
2019年04期
页码:
587-592
栏目:
应用研究
出版日期:
2019-07-20

文章信息/Info

Title:
Low molecular weight heparin for the prevention and treatment of hypertensive disorders complicating pregnancy:a meta-analysis
作者:
许雅娟孙宗宗翟闪闪余艳茹班彦杰张 淼张婧喆王 彪
郑州大学第三附属医院产科 郑州 450052
Author(s):
XU YajuanSUN ZongzongZHAI ShanshanYU YanruBAN YanjieZHANG Miao ZHANG JingzheWANG Biao
Department of Obstetrics, the Third Affiliated Hospital,Zhengzhou University, Zhengzhou 450052
关键词:
低分子肝素 阿司匹林 妊娠期高血压疾病 meta分析
Keywords:
low molecular weight heparin aspirin hypertensive disorder complicating pregnancy meta-analysis
分类号:
R714
DOI:
10.13705/j.issn.1671-6825.2018.10.131
摘要:
目的:系统评价低分子肝素(LMWH)防治妊娠期高血压疾病的效果和安全性。方法:系统检索了PubMed、EMbase、Cochrane Library等各大数据库发表于2017年12月之前的原创性随机对照试验(RCT),提取有效数据,对于数据不完整者通过联系作者获得。采用软件RevMan 5.3进行meta分析,Cochrane偏倚风险工具评估偏倚风险。结果:共纳入9篇RCT文献,对1 140(LMWH组571,对照组569)名研究对象进行meta分析的结果表明,LMWH可以降低胎盘介导的妊娠并发症的复发率(OR=0.43,95%CI=0.28~0.66)、妊娠期高血压疾病复发率(OR=0.58,95%CI=0.41~0.83)及新生儿死亡率(OR=0.25,95%CI=0.07~0.82)等; 但使用LMWH后药物过敏风险增加(OR=10.89,95%CI=1.32~90.05),使用LMWH对产时产后出血、骨质疏松、血小板减少无影响。 LMWH联合阿司匹林在预防妊娠期高血压疾病再发方面优于单用LMWH(P<0.001)。结论:现有证据显示LMWH用于妊娠期高血压疾病的防治安全有效,且LMWH与阿司匹林联用效果优于单用LMWH。
Abstract:
Aim:To systematically evaluate the efficacy and safety of low molecular weight heparin(LMWH)for the prevention and treatment of hypertensive disorder complicating pregnancy(HDCP).Methods:Data from randomized controlled trials delivered before December 2017 were obtained from databases of PubMed,EMbase,Cochrane Library and other major databases, supplemented by manual retrieval. For the incomplete data, we contacted the authors to obtain. Meta-analysis was performed using the software RevMan 5.3, and the Cochrane biased risk tool was used to assess the risk of bias.Results:Meta-analysis was used to analyze the subjects from 9 studies which included 1 140 subjects[LMWH group(n=571)vs control group(n=569)],and the results showed that LMWH could reduce placental-mediated recurrence rate of pregnancy complications(OR=0.43, 95%CI=0.28-0.66),recurrence rate of HDCP(OR=0.58, 95%CI=0.41-0.83), neonatal mortality(OR=0.25,95%CI=0.07-0.82), etc.; however, the risk of drug allergy increased after using LMWH(OR=10.89, 95%CI=1.32-90.05).LMWH had no effects on postpartum hemorrhage,osteoporosis,and thrombocytopenia,and the combination of LMWH and ASA was superior to LMWH alone(P<0.001).Conclusion:LMWH is safe and effective for the prevention and treatment of HDCP,and the combination of LMWH and ASA is superior to LMWH alone.

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备注/Memo

备注/Memo:
【基金项目】郑州市科技局项目(CZSYJJ16037)
【作者简介】许雅娟,通信作者,女,1963年4月生,教授,主任医师,硕士研究生导师,研究方向:围产医学,E-mail:cnzzzsl@163.com
更新日期/Last Update: 2019-07-20