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许雷来,毛佩瑜,鲁东红.甲氨蝶呤不同肌注方案治疗异位妊娠的meta分析[J].浙江中西医结合杂志,2018,28(9):
甲氨蝶呤不同肌注方案治疗异位妊娠的meta分析
A Meta-analysis for the treatment of ectopic pregnancy with different intramuscular injection regimen of methotrexate. Leilai Xu,Peiyu Mao,Donghong Lu.Department of Obstetrics and gynecology, the First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310006,China.
投稿时间:2017-11-03  修订日期:2018-07-27
DOI:
中文关键词:  异位妊娠  甲氨蝶呤  肌注  meta分析
英文关键词:ectopic pregnancy  MTX  intramuscular injection  Meta-analysis
基金项目:浙江中医药大学校级科研基金项目(2018ZZ03)
作者单位E-mail
许雷来 浙江中医药大学附属第一医院妇产科 xll1005@126.com 
毛佩瑜 浙江中医药大学附属第一医院妇产科  
鲁东红 浙江中医药大学附属第一医院妇产科 xll1005@126.com 
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中文摘要:
      【】 目的:比较甲氨蝶呤(MTX)单次与多次肌注治疗异位妊娠的疗效及安全性。方法:检索PUBMED、EMBASE、Cochrane 图书馆、中国知网数据库、万方数据库、中国科技论文数据库、临床医学文献数据库,从建库至2017年8月甲氨蝶呤不同肌注方案治疗异位妊娠的随机对照试验研究,筛选合格研究。应用Cochrane风险偏倚评估工具进行偏倚风险评价。应用RevMan5.3软件进行Meta分析。结果:符合纳入标准的文献共15篇,共纳入1564例患者。Meta分析结果提示:甲氨蝶呤单次肌注组治愈率显著高于多次肌注组,差异具有统计学意义(OR=1.60,95% CI 1.05~2.45, P=0.03),亚组分析结果提示甲氨蝶呤单次肌注组治愈率低于两次肌注组,两者差异无统计学意义(P=0.19);甲氨蝶呤单次肌注组治愈率高于多次(>2次)肌注组,两者差异具有统计学意义(P<0.00001);甲氨蝶呤单次肌注组副反应率低于多次肌注甲氨蝶呤组,差异具有统计学意义(OR=0.63,95% CI 0.48~0.81,P=0.0005);甲氨蝶呤单次肌注组重复用药率高于多次肌注组,差异具有统计学意义(OR=3.06,95% CI 1.15~8.17, P=0.03)。结论:甲氨蝶呤治疗异位妊娠单次肌注的疗效优于多次肌注,单次肌注药物副反应发生率更低,安全性更高,但仍存在重复用药的可能。
英文摘要:
      【】 Objective Comparison of the efficacy and safety of single-dose MTX regimen and multiple-dose MTX regimen in the treatment of ectopic pregnancy.Methods Related information about randomized clinical trials (RCTs) of methotrexate single and multiple intramuscular injection in the treatment of ectopic pregnancy in PUBMED,EMBASE, Cochrane Library,CNKI Database,Wanfang Database, China Science and technology paper database,Clinical medical literature database from the inception of each database up to August 2017 is electronically searched.The Cochrane risk of bias tool is used to assess the risk of bias.The Cochrane Collaboration"s RevMan 5.3 software is used for meta-analysis.Results A total of 15 articles are included in the inclusion criteria, and 1564 patients are included. Meta analysis results suggest that the cure rate of single-dose regimen group is significantly higher than the multiple-dose regimen group, the difference is statistically significant (OR=1.60,95% CI 1.05~2.45, P=0.03),Subgroup analysis showed that the cure rate of single-dose regimen group is lower than two-dose regimen group, the difference is not statistically significant (P = 0.19); single-dose regimen group is higher than multiple-dose (> 2) regimen group, the difference is statistically significant(P<0.00001);Side effects rate of single-dose regimen group significantly lower than multiple-dose regimen group(OR=0.63,95% CI 0.48~0.81, P=0.0005);Repetitive rate of single-dose regimen group is higher than the multiple-dose regimen group, the difference is statistically significant(OR=3.06, 95% CI 1.15~8.17,P=0.03).Conclusion treatment with single-dose MTX regimen has better cure rate and fewer side-effects than multiple-dose MTX regimen in ectopic pregnancy,but there is still possibility of repeated use of MTX.
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