Treatment of Naloxone for Moderate and Severe Neonatal Hypoxia-ischemic Encephalopathy:A Meta-analysis_West China Medical Journal

Authors：

 LiaoRuixue ^1,2 , YangYang ¹ ,  LiuYanhui ¹

1. Nursing College, Tianjin University of Traditional Chinese Medicine, Tianjin 300000, P. R. China;
2. Xiangyang Stomatological Hospital, Xiangyang, Hubei 441000, P. R. China;

Corresponding?author：

LiuYanhui, Email: yh_liu888@163.com

Keywords：

Naloxone; Hypoxia-ischemic encephalopathy; Neonates; Meta-analysis

DOI：

10.7507/1002-0179.201600368

Video：

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Objective To objectively evaluate the effect and safety of naloxone for the treatment of moderate and severe neonatal hypoxia-ischemic encephalopathy (HIE). Methods Research articles published from inception to June 2015 on Cochrane library, PubMed, Web of science, Chinese Science and Technology Journal Full-text Database, Digital Full-text Journal Database and Chinese Journal Full-text Database were searched, which were relevant to naloxone in the treatment of moderate and severe neonatal HIE. And two authors extracted information via standardized data extraction form and assessed the quality of included studies independently. RevMan 5.2 software was used for Meta-analysis. Results At last, 20 randomized controlled trials (involving 1 519 neonates; 783 in the treatment group and 736 in the control group) were included. The results of meta-analysis showed that the effect of naloxone for moderate and severe HIE was significantly superior to the control group[OR=5.07, 95%CI (3.61, 7.12), P < 0.000 01]. The neurobehavioral scores in neonates treated by naloxone after 5, 7, 10, and 14 days were higher than those in the control group[WMD=6.61 points, 95%CI (5.70, 7.51) points, P < 0.000 01; WMD=4.27 points, 95%CI (2.63, 5.91) points, P < 0.000 01; WMD=2.40 points, 95%CI (1.47, 3.34) points, P < 0.000 01; WMD=2.58 points, 95%CI (1.00, 4.16) points, P=0.001], respectively; while the neurobehavioral scores after 3-day treatment between the two groups had no statistically difference[WMD=0.00 points, 95%CI(-0.76, 0.77) points, P=0.99]. What's more, the disappeared time of clinical symptoms and signs (breathing improvement time, recovery time, convulsions disappearance time, and signs disappearance time) in naloxone group was superior to the control groups[WMD=-3.78 hours, 95%CI (-6.93, -0.64) hours, P=0.02; WMD=-9.66 hours, 95%CI (-14.25, -5.06) hours, P < 0.001; WMD=-2.81 hours, 95%CI (-5.28, -0.35) hours, P=0.03; WMD=-1.02 days, 95%CI (-1.84, -0.20) days, P=0.01], respectively. Conclusions Naloxone has certain therapeutic on moderate and severe HIE. Further high-quality randomized controlled trials should be carried out to provide more reliable evidence.

Citation： LiaoRuixue, YangYang, LiuYanhui. Treatment of Naloxone for Moderate and Severe Neonatal Hypoxia-ischemic Encephalopathy:A Meta-analysis. West China Medical Journal, 2016, 31(8): 1344-1351. doi: 10.7507/1002-0179.201600368 Copy

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2.	郭江雪.納洛酮治療新生兒缺氧缺血性腦病50例療效觀察[J].中華全科醫學, 2011, 9(2):233-331.
3.	謝健.新生兒缺氧缺血性腦病相關因素及臨床特點[J].現代醫藥衛生, 2011, 27(14):2090-2091.
4.	薛碧萍.新生兒缺氧缺血性腦病治療進展[J].醫學信息, 2011, 4(6):2571-2572.
5.	韓玉昆, 虞人杰, 卜定方.新生兒缺氧缺血性腦病臨床診斷依據和分度[J].中華兒科雜志, 1990, 28(1):31.
6.	中華醫學會兒科會新生兒學組.新生兒缺氧缺血性腦病臨床診斷依據和臨床分度[J].中華兒科雜志, 1997, 35(2):99-100.
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9.	陳立軍.新生兒缺氧缺血性腦病臨床分析[J].中外醫學研究, 2012, 10(30):22-23.
10.	李紅梅, 吳靜, 黃健蘭.新生兒缺血缺氧性腦病實施早期干預治療的療效與預后分析[J].中國婦幼保健, 2010, 25(23):3291-3293.
11.	李衡.納洛酮治療中重度新生兒缺氧缺血性腦病的效果觀察[J].中國保健營養, 2014, 24(2):1045.
12.	齊燁.新生兒缺氧缺血性腦病早期干預及對預后影響的研究[J].醫藥論壇雜志, 2011, 32(3):22-26.
13.	榮久莉, 王艷煥, 陳淑紅, 等.納洛酮治療新生兒缺血缺氧性腦病臨床療效觀察[J].醫學創新研究, 2006, 3(10):128.
14.	覃立剛.新生兒中重度缺氧缺血性腦病48例病情分析及治療[J].中國現代藥物應用, 2011, 5(10):7-8.
15.	田霞.納洛酮治療中重度新生兒缺氧缺血性腦病療效觀察[J].醫學信息, 2010, 23(5):96.
16.	張學聰, 晁占湖, 王有福.納洛酮治療中重度新生兒缺氧缺血性腦病的療效觀察[J].河南實用神經疾病雜志, 2004, 7(2):65-66.
17.	趙國華, 楊海娟, 邊靜.納洛酮治療中、重度新生兒缺氧缺血性腦病臨床觀察[J].中國醫學文摘, 2006, 25(2):85-86.
18.	詹新勇.納洛酮治療中重度新生兒缺氧缺血性腦病的療效分析[J].醫學信息, 2013, 26(8):638.
19.	張志新, 閆利紅, 王長華, 等.納洛酮在中重度新生兒缺氧缺血性腦病治療中的應用[J].中國婦幼保健, 2013, 28(7):1120-1121.
20.	張海燕, 張聰.納洛酮治療新生兒缺氧缺血性腦病的臨床觀察[J].中外醫學研究, 2012, 10(14):34.
21.	張立鳳.納洛酮治療新生兒缺氧缺血性腦病[J].內蒙古中醫藥, 2013, 32(14):58.
22.	魏梁, 高存亮.納洛酮治療新生兒缺氧缺血性腦病47例[J].中國社區醫師, 2008, 10(17):99.
23.	賴冰瑩, 林廣裕, 王維成, 等.常規用納洛酮治療中、重度新生兒缺氧缺血性腦病的療效觀察[J].寧夏醫學雜志, 2002, 24(4):214-215.
24.	孫順清.納洛酮佐治新生兒缺氧缺血性腦病65例療效觀察[J].陜西醫學雜志, 2008, 37(7):906.
25.	馬文旭, 李秀巖, 劉衍華.納洛酮治療新生兒缺氧缺血性腦病的臨床分析[J].中外健康文摘, 2010, 7(22):53-54.
26.	李寶芹, 王振營, 楊小寧, 等.早期應用納洛酮治療新生兒缺氧缺血性腦病療效觀察[J].上海醫藥, 1999, 20(5):17-18.
27.	李翠英, 馬桂香.納洛酮治療中重度新生兒缺氧缺血性腦病的療效觀察[J].兒科藥學雜志, 2003, 9(4):56-57.

1. de Vries LS, Cowan FM. Evolving understanding of hypoxic-ischemic encephalopathy in the term infant[J]. Semin Pediatr Neurol, 2009, 16(4):216-225.
2. 郭江雪.納洛酮治療新生兒缺氧缺血性腦病50例療效觀察[J].中華全科醫學, 2011, 9(2):233-331.
3. 謝健.新生兒缺氧缺血性腦病相關因素及臨床特點[J].現代醫藥衛生, 2011, 27(14):2090-2091.
4. 薛碧萍.新生兒缺氧缺血性腦病治療進展[J].醫學信息, 2011, 4(6):2571-2572.
5. 韓玉昆, 虞人杰, 卜定方.新生兒缺氧缺血性腦病臨床診斷依據和分度[J].中華兒科雜志, 1990, 28(1):31.
6. 中華醫學會兒科會新生兒學組.新生兒缺氧缺血性腦病臨床診斷依據和臨床分度[J].中華兒科雜志, 1997, 35(2):99-100.
7. Higgins JPI, Green S. Cochrane handbook for systematic reviews of interventions version 5.1.0[updated March 2011] [EB/OL].(2012-08-25)[2015-01-01]. The Cochrane Collaboration 2011. http://www.Cochrane-handbook.org.
8. 何忠芳, 劉芳, 翟所迪, 等.他汀類藥物對腦梗死患者C-反應蛋白和頸動脈內中膜厚度影響的系統評價[J].中國循證醫學雜志, 2009, 9(8):873.
9. 陳立軍.新生兒缺氧缺血性腦病臨床分析[J].中外醫學研究, 2012, 10(30):22-23.
10. 李紅梅, 吳靜, 黃健蘭.新生兒缺血缺氧性腦病實施早期干預治療的療效與預后分析[J].中國婦幼保健, 2010, 25(23):3291-3293.
11. 李衡.納洛酮治療中重度新生兒缺氧缺血性腦病的效果觀察[J].中國保健營養, 2014, 24(2):1045.
12. 齊燁.新生兒缺氧缺血性腦病早期干預及對預后影響的研究[J].醫藥論壇雜志, 2011, 32(3):22-26.
13. 榮久莉, 王艷煥, 陳淑紅, 等.納洛酮治療新生兒缺血缺氧性腦病臨床療效觀察[J].醫學創新研究, 2006, 3(10):128.
14. 覃立剛.新生兒中重度缺氧缺血性腦病48例病情分析及治療[J].中國現代藥物應用, 2011, 5(10):7-8.
15. 田霞.納洛酮治療中重度新生兒缺氧缺血性腦病療效觀察[J].醫學信息, 2010, 23(5):96.
16. 張學聰, 晁占湖, 王有福.納洛酮治療中重度新生兒缺氧缺血性腦病的療效觀察[J].河南實用神經疾病雜志, 2004, 7(2):65-66.
17. 趙國華, 楊海娟, 邊靜.納洛酮治療中、重度新生兒缺氧缺血性腦病臨床觀察[J].中國醫學文摘, 2006, 25(2):85-86.
18. 詹新勇.納洛酮治療中重度新生兒缺氧缺血性腦病的療效分析[J].醫學信息, 2013, 26(8):638.
19. 張志新, 閆利紅, 王長華, 等.納洛酮在中重度新生兒缺氧缺血性腦病治療中的應用[J].中國婦幼保健, 2013, 28(7):1120-1121.
20. 張海燕, 張聰.納洛酮治療新生兒缺氧缺血性腦病的臨床觀察[J].中外醫學研究, 2012, 10(14):34.
21. 張立鳳.納洛酮治療新生兒缺氧缺血性腦病[J].內蒙古中醫藥, 2013, 32(14):58.
22. 魏梁, 高存亮.納洛酮治療新生兒缺氧缺血性腦病47例[J].中國社區醫師, 2008, 10(17):99.
23. 賴冰瑩, 林廣裕, 王維成, 等.常規用納洛酮治療中、重度新生兒缺氧缺血性腦病的療效觀察[J].寧夏醫學雜志, 2002, 24(4):214-215.
24. 孫順清.納洛酮佐治新生兒缺氧缺血性腦病65例療效觀察[J].陜西醫學雜志, 2008, 37(7):906.
25. 馬文旭, 李秀巖, 劉衍華.納洛酮治療新生兒缺氧缺血性腦病的臨床分析[J].中外健康文摘, 2010, 7(22):53-54.
26. 李寶芹, 王振營, 楊小寧, 等.早期應用納洛酮治療新生兒缺氧缺血性腦病療效觀察[J].上海醫藥, 1999, 20(5):17-18.
27. 李翠英, 馬桂香.納洛酮治療中重度新生兒缺氧缺血性腦病的療效觀察[J].兒科藥學雜志, 2003, 9(4):56-57.

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Treatment of Naloxone for Moderate and Severe Neonatal Hypoxia-ischemic Encephalopathy:A Meta-analysis

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