硝酸甘油辅助治疗大咯血的临床有效性和安全性的系统评价

Systematic Review of the Therapeutic Efficacy and Safety of Nitroglycerin in the Adjunctive Treatment of Massive Hemoptysis

关键词:  硝酸甘油  大咯血  临床有效性  安全性  meta分析

Key words:  nitroglycerin  massive hemoptysis  therapeutic efficacy  safety  meta analysis

摘要:

目的 系统评价硝酸甘油辅助治疗大咯血的临床疗效和安全性。方法 计算机检索PubMed、CNKI、VIP、CBM、万方等数据库公开发表的垂体后叶素联用硝酸甘油治疗大咯血的的随机对照试验(RCT)，检索年限均为1990—2014年，采用Rev Man 5.2 统计学软件进行Meta分析。结果 共纳入20篇RCT，合计1 770例患者。垂体后叶素联用硝酸甘油较垂体后叶素单用能显著提高大咯血的临床有效性[RR=0.81，95%CI(0.77，0.84)，P<0.01]，同时硝酸甘油能显著减少垂体后叶素致药物不良反应的发生[RR=3.08，95%CI(2.59，3.68)，P<0.01]，特别在心血管系统、中枢神经系统和消化系统等方面。结论 现有证据表明，硝酸甘油辅助治疗大咯血疗效确切，安全性好。

Abstract:

OBJECTIVE To evaluate therapeutic efficacy and safety of nitroglycerin in the adjunctive treatment of massive hemoptysis. METHODS Retrieved from PubMed, CNKI, VIP, CBM and Wangfang database, randomized controlled trials(RCT) about pituitrin combined with nitroglycerin compared with pituitrin alone in the treatment of massive hemoptysis were included. Rev Man 5.2 software was used for Meta analysis. RESULTS Twenty RCTs were included, invovling 1 770 patients. Meta-analysis showed that compared with pituitrin alone, pituitrin combined with nitroglycerin could significantly improve clinical efficiency [RR=0.81, 95%CI(0.77, 0.84), P<0.0], and nitroglycerin could significantly reduce adverse drug reactions induced by pituitrin[RR=3.08, 95%CI(2.59,3.68), P<0.01], especially in the cardiovascular system, central nervous system and digestive system etc. CONCLUSION The available evidence indicates that nitroglycerin can be applied in the adjunctive treatment of massive hemoptysis with little side effect and good patient tolerance.