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.纳洛酮治疗新生儿缺氧缺血性脑病50例疗效观察[J].中华全科医学, 2011, 9(2):233-331.
3.	谢健.新生儿缺氧缺血性脑病相关因素及临床特点[J].现代医药卫生, 2011, 27(14):2090-2091.
4.	薛碧萍.新生儿缺氧缺血性脑病治疗进展[J].医学信息, 2011, 4(6):2571-2572.
5.	韩玉昆, 虞人杰, 卜定方.新生儿缺氧缺血性脑病临床诊断依据和分度[J].中华儿科杂志, 1990, 28(1):31.
6.	中华医学会儿科会新生儿学组.新生儿缺氧缺血性脑病临床诊断依据和临床分度[J].中华儿科杂志, 1997, 35(2):99-100.
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10.	李红梅, 吴静, 黄健兰.新生儿缺血缺氧性脑病实施早期干预治疗的疗效与预后分析[J].中国妇幼保健, 2010, 25(23):3291-3293.
11.	李衡.纳洛酮治疗中重度新生儿缺氧缺血性脑病的效果观察[J].中国保健营养, 2014, 24(2):1045.
12.	齐烨.新生儿缺氧缺血性脑病早期干预及对预后影响的研究[J].医药论坛杂志, 2011, 32(3):22-26.
13.	荣久莉, 王艳焕, 陈淑红, 等.纳洛酮治疗新生儿缺血缺氧性脑病临床疗效观察[J].医学创新研究, 2006, 3(10):128.
14.	覃立刚.新生儿中重度缺氧缺血性脑病48例病情分析及治疗[J].中国现代药物应用, 2011, 5(10):7-8.
15.	田霞.纳洛酮治疗中重度新生儿缺氧缺血性脑病疗效观察[J].医学信息, 2010, 23(5):96.
16.	张学聪, 晁占湖, 王有福.纳洛酮治疗中重度新生儿缺氧缺血性脑病的疗效观察[J].河南实用神经疾病杂志, 2004, 7(2):65-66.
17.	赵国华, 杨海娟, 边静.纳洛酮治疗中、重度新生儿缺氧缺血性脑病临床观察[J].中国医学文摘, 2006, 25(2):85-86.
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19.	张志新, 闫利红, 王长华, 等.纳洛酮在中重度新生儿缺氧缺血性脑病治疗中的应用[J].中国妇幼保健, 2013, 28(7):1120-1121.
20.	张海燕, 张聪.纳洛酮治疗新生儿缺氧缺血性脑病的临床观察[J].中外医学研究, 2012, 10(14):34.
21.	张立凤.纳洛酮治疗新生儿缺氧缺血性脑病[J].内蒙古中医药, 2013, 32(14):58.
22.	魏梁, 高存亮.纳洛酮治疗新生儿缺氧缺血性脑病47例[J].中国社区医师, 2008, 10(17):99.
23.	赖冰莹, 林广裕, 王维成, 等.常规用纳洛酮治疗中、重度新生儿缺氧缺血性脑病的疗效观察[J].宁夏医学杂志, 2002, 24(4):214-215.
24.	孙顺清.纳洛酮佐治新生儿缺氧缺血性脑病65例疗效观察[J].陕西医学杂志, 2008, 37(7):906.
25.	马文旭, 李秀岩, 刘衍华.纳洛酮治疗新生儿缺氧缺血性脑病的临床分析[J].中外健康文摘, 2010, 7(22):53-54.
26.	李宝芹, 王振营, 杨小宁, 等.早期应用纳洛酮治疗新生儿缺氧缺血性脑病疗效观察[J].上海医药, 1999, 20(5):17-18.
27.	李翠英, 马桂香.纳洛酮治疗中重度新生儿缺氧缺血性脑病的疗效观察[J].儿科药学杂志, 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.纳洛酮治疗新生儿缺氧缺血性脑病50例疗效观察[J].中华全科医学, 2011, 9(2):233-331.
3. 谢健.新生儿缺氧缺血性脑病相关因素及临床特点[J].现代医药卫生, 2011, 27(14):2090-2091.
4. 薛碧萍.新生儿缺氧缺血性脑病治疗进展[J].医学信息, 2011, 4(6):2571-2572.
5. 韩玉昆, 虞人杰, 卜定方.新生儿缺氧缺血性脑病临床诊断依据和分度[J].中华儿科杂志, 1990, 28(1):31.
6. 中华医学会儿科会新生儿学组.新生儿缺氧缺血性脑病临床诊断依据和临床分度[J].中华儿科杂志, 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, 刘芳, 翟所迪, 等.他汀类药物对脑梗死患者C-反应蛋白和颈动脉内中膜厚度影响的系统评价[J].中国循证医学杂志, 2009, 9(8):873.
9. 陈立军.新生儿缺氧缺血性脑病临床分析[J].中外医学研究, 2012, 10(30):22-23.
10. 李红梅, 吴静, 黄健兰.新生儿缺血缺氧性脑病实施早期干预治疗的疗效与预后分析[J].中国妇幼保健, 2010, 25(23):3291-3293.
11. 李衡.纳洛酮治疗中重度新生儿缺氧缺血性脑病的效果观察[J].中国保健营养, 2014, 24(2):1045.
12. 齐烨.新生儿缺氧缺血性脑病早期干预及对预后影响的研究[J].医药论坛杂志, 2011, 32(3):22-26.
13. 荣久莉, 王艳焕, 陈淑红, 等.纳洛酮治疗新生儿缺血缺氧性脑病临床疗效观察[J].医学创新研究, 2006, 3(10):128.
14. 覃立刚.新生儿中重度缺氧缺血性脑病48例病情分析及治疗[J].中国现代药物应用, 2011, 5(10):7-8.
15. 田霞.纳洛酮治疗中重度新生儿缺氧缺血性脑病疗效观察[J].医学信息, 2010, 23(5):96.
16. 张学聪, 晁占湖, 王有福.纳洛酮治疗中重度新生儿缺氧缺血性脑病的疗效观察[J].河南实用神经疾病杂志, 2004, 7(2):65-66.
17. 赵国华, 杨海娟, 边静.纳洛酮治疗中、重度新生儿缺氧缺血性脑病临床观察[J].中国医学文摘, 2006, 25(2):85-86.
18. 詹新勇.纳洛酮治疗中重度新生儿缺氧缺血性脑病的疗效分析[J].医学信息, 2013, 26(8):638.
19. 张志新, 闫利红, 王长华, 等.纳洛酮在中重度新生儿缺氧缺血性脑病治疗中的应用[J].中国妇幼保健, 2013, 28(7):1120-1121.
20. 张海燕, 张聪.纳洛酮治疗新生儿缺氧缺血性脑病的临床观察[J].中外医学研究, 2012, 10(14):34.
21. 张立凤.纳洛酮治疗新生儿缺氧缺血性脑病[J].内蒙古中医药, 2013, 32(14):58.
22. 魏梁, 高存亮.纳洛酮治疗新生儿缺氧缺血性脑病47例[J].中国社区医师, 2008, 10(17):99.
23. 赖冰莹, 林广裕, 王维成, 等.常规用纳洛酮治疗中、重度新生儿缺氧缺血性脑病的疗效观察[J].宁夏医学杂志, 2002, 24(4):214-215.
24. 孙顺清.纳洛酮佐治新生儿缺氧缺血性脑病65例疗效观察[J].陕西医学杂志, 2008, 37(7):906.
25. 马文旭, 李秀岩, 刘衍华.纳洛酮治疗新生儿缺氧缺血性脑病的临床分析[J].中外健康文摘, 2010, 7(22):53-54.
26. 李宝芹, 王振营, 杨小宁, 等.早期应用纳洛酮治疗新生儿缺氧缺血性脑病疗效观察[J].上海医药, 1999, 20(5):17-18.
27. 李翠英, 马桂香.纳洛酮治疗中重度新生儿缺氧缺血性脑病的疗效观察[J].儿科药学杂志, 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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