摘要
目的系统评价环孢素用药剂量及疗程对不良妊娠结局的影响。方法检索中国知网、万方、维普医学网、Pubmed、Cochran Library等数据库自建库至2023年9月发表的关于环孢素治疗不良妊娠的随机对照研究及观察性研究的文献,采用Revmen 5.3软件进行质量评价和Meta分析。结果共纳入19篇文献,共涉及1902例患者,其中进行环孢素治疗患者共919例。试验组临床妊娠率71.2%,流产率12.7%,不良反应发生率4.7%;对照组临床妊娠率55.4%,流产率25.3%,不良反应发生率7.1%。当环孢素日剂量在240~480 mg范围内,试验组的临床妊娠率与对照组差异具有统计学意义(P<0.01);用药疗程在妊娠开始前30 d至孕12周,试验组的临床妊娠率与对照组差异具有统计学意义(P<0.01)。结论环孢素在适宜的剂量和合理的用药疗程内能提高不良妊娠的临床妊娠率,降低流产率,且不良反应发生率较低。
Objective To systematically evaluate the effects of cyclosporine dose and course of treatment on pregnancy outcomes.Methods The literature of randomized controlled studies and observational studies on the treatment of adverse pregnancy with cyclosporine was searched from the establishment of various scientific databases at home and abroad(CNKI,Wanfang,VIP Medical Network,Pubmed,Cochran Library)to September 2023.Revmen 5.3 was used for quality assessment and meta-analysis of the included studies.Results A total of 19 studies involving 1902 patients were included,of which 919 patients were treated with cyclosporine.The clinical pregnancy rate,miscarriage rate and adverse reaction rate in the experimental group were 71.2%,12.7%and 4.7%,respectly.In the control group,the clinical pregnancy rate was 55.4%,the miscarriage rate was 25.3%,and the incidence of adverse reactions was 7.1%.The results showed that when the daily dose of cyclosporine was in the range of 240-480 mg,the clinical pregnancy rate of the experimental group was significantly different from that of the control group(P<0.01).The medication course was from 30 days before the start of pregnancy to 12 weeks of pregnancy,and there was a significant difference in the clinical pregnancy rate between the experimental group and the control group(P<0.01).Conclusion At present,limited evidence suggests that cyclosporine can increase the clinical pregnancy rate of adverse pregnancies,reduce miscarriage rates,and have a low incidence of adverse reactions at appropriate doses and reasonable treatment courses.
作者
王茂娇
程小桂
扶忠超
叶陈丽
张鹏
史冉庚
曹伟灵
WANG Maojiao;CHENG Xiaogui;FU Zhongchao;YE Chenli;ZHANG Peng;SHI Rangeng;CAO Weiling(College of Pharmacy,Dali University,Dali Bai Autonomous Prefecture,Dali 671003,China;Department of Pharmcy,The People’s Hospital of LuohuDistrict in Shenzhen,Shenzhen 518000,China;Department of Rheumatology and Immunology,The People’s Hospital of Luohu District in Shenzhen,Shenzhen 518000,China)
出处
《广东药科大学学报》
CAS
2024年第6期68-75,共8页
Journal of Guangdong Pharmaceutical University
基金
三名工程中国药科大学王广基院士精准药学团队项目(SZSM202301035)。
关键词
环孢素
药物剂量
疗程
不良妊娠
妊娠结局
cyclosporine
drug dosage
course of treatment
adverse pregnancy
pregnancy outcomes
