1,6-二磷酸果糖治療新生兒缺氧缺血性腦病的系統評價_《中國循證醫學雜志》

作者：

劉芳 , 翟所迪

北京大學第三醫院藥劑科,北京100083;

關鍵詞：

1,6-二磷酸果糖新生兒缺氧缺血性腦病系統評價

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目的　評價1,6-二磷酸果糖(FDP)治療新生兒缺氧缺血性腦病(HIE)的療效與安全性.
方法　計算機檢索MEDLINE(1977～2004年)、EMBASE(1989～2004年)、Cochrane圖書館(2004年第4期)、CBM(1978～2004年)和CNKI(1994～2005年)等文獻數據庫,收集FDP治療HIE的臨床研究和系統評價,進行質量評價,并對符合納入標準的臨床研究進行Meta分析.
結果　共納入9項隨機對照研究,全部為中文.5項研究的JADAD評分為2分,4項研究為1分.各研究均未描述具體的隨機方法,未進行分配方案的隱藏.所有研究均未使用盲法.7項研究報道了治療過程中的死亡例數, 5項研究進行了隨訪.與安慰劑或空白對照比較,FDP組死亡的OR(95%CI)為0.50(0.21,1.16),腦癱的OR(95%CI) 0.36(0.19,0.89),癲癇的OR(95%CI)為0.74(0.29,1.88),智力低下的OR(95%CI)為0.21(0.06,0.70).由于缺乏高質量的臨床研究,上述Meta分析中未進行敏感性分析.未檢索到評價FDP用于HIE安全性的評價研究.
結論　目前FDP用于HIE的臨床研究普遍質量較低.由于缺乏高質量的臨床研究,FDP用于治療HIE的有效性缺乏證據.

引用本文： 劉芳,翟所迪. 1,6-二磷酸果糖治療新生兒缺氧缺血性腦病的系統評價. 中國循證醫學雜志, 2005, 05(9): 696-701. doi: 復制

1.	高瑛. 新生兒缺氧缺血性腦病的治療研究進展[J]. 臨床兒科雜志, 2004; 22(8): 568～570.
2.	"九五"攻關項目HIE治療協作組.新生兒缺氧缺血性腦病治療方案(試行稿)[J]. 中國實用兒科雜志, 2000; 15(6): 381～382.
3.	李樹青, 李乃琪, 李麗, 譚華清, 徐愛晶. 1,6-二磷酸果糖治療新生兒缺氧缺血性腦病[J]. 實用兒科雜志, 1998; 13(1): 47.
4.	邵雷. 1,6-二磷酸果糖治療新生兒缺氧缺血性腦病[J]. 腦與神經疾病雜志, 1998; 6(6): 335.
5.	葉斌. 1,6-二磷酸果糖治療新生兒缺氧缺血性腦病療效觀察及預后探討[J]. 新生兒科雜志, 2000; 15(3): 114～115.
6.	卓志強, 鄭瑞霞, 施燕禧, 王素香. 果糖二磷酸鈉治療新生兒缺氧缺血性腦病療效觀察[J]. 中國醫院藥學雜志, 2000; 20(1): 19～20.
7.	況琦.1,6-二磷酸果糖治療新生兒缺氧缺血性腦病觀察[J]. 河南醫藥信息, 2001; 9(12): 10.
8.	楊康治, 陳正珊, 吳少華. 行為神經測定對1,6二磷酸果糖治療新生兒缺氧缺血性腦病的療效評價[J]. 實用醫學雜志, 2001; 17(4): 363.
9.	楊秀芬, 于清, 張春躍. 1,6-二磷酸果糖治療新生兒缺氧缺血性腦病療效觀察及預后探討[J]. 中國優生與遺傳雜志, 2001; 9(4): 76.
10.	王吉耀. 循證醫學與臨床實踐[M]. 第1版. 北京: 科學出版社, 2002. p. 59.
11.	Gao Y. Progress in the research of Hypoxic Ischemic Encephalopathy treatment[J]. Journal of Clinical Pediatrics, 2004; 22(8): 568-570.
12.	Ferriero, Donna M. Medical Progress: Neonatal Brain Injury[J]. New England Journal of Medicine, 2004; 351(19): 1985-1995.
13.	National key scientific and technological project-Cooperation Group of HIE treatment. Pilot plan for the treatment of Hypoxic Ischemic Encephalopathy[J]. Chinese Journal of Practical Pediatrics, 2000; 15(6): 381-382.
14.	Jadad AR, Moore A, Carroll D, Jenkinson C, Reynolds JM, Gavaghan DJ. Assessing the quality of reports of randomized clinical trials: Is blinding necessary[J]. Control Clin Trials, 1996; 17(1): 1-12.
15.	Li SQ, Li NQ, Li L, Tan HQ, Xu AJ. 1,6-fructose diphosphate in treating of Hypoxic Ischemic Encephalopathy[J]. Journal of Practical Pediatrics, 1998; 13(1): 47.
16.	Shao L. 1,6-fructose diphosphate for treatment of Hypoxic Ischemic Encephalopathy[J]. Journal of Brain and Nervous Disease, 1998; 6(6): 335.
17.	Ye B. Therapeutic effects and prognosis of fructose 1,6-diphosphate in treating Hypoxic Ischemic Encephalopathy[J]. Journal of Neonatolog, 2000; 15(3): 114-115.
18.	Zhuo ZQ, Zheng RX, Shi YX, Wang SX. Observation of curative effect of Fructose-1,6-Diphosphate in treating Hypoxic Ischemic Encephalopathy[J]. Journal of Hospital Pharmacy, 2000; 20(1): 19-20.
19.	Kuang Q. Study of fructose-1,6-diphosphate on the treatment of Hypoxic Ischemic Encephalopathy[J]. He Nan Medical Information, 2001; 9(12): 10.
20.	Yang KZ, Chen ZS, Wu SH. Evaluation the efficacy of Fructose-1,6-Diphosphate for Hypoxic Ischemic Encephalopathy with neonatal behavior neurologic assessment[J]. The Journal of Practical Medicine, 2001; 17(4): 363.
21.	Yang XF, Yu Q, Zhang CY. Efficacy and prognosis of Fructose-1,6-Diphosphate on Hypoxic Ischemic Encephalopathy[J]. Chinese Journal of Birth Health and Heredity, 2001; 9(4): 76.
22.	Hao YZ, Diao JX. Effect of fructose 1,6-diphosphate administration in 106 cases of Hypoxic Ischemic Encephalopathy [J]. Shandong Medical Journal, 2002; 42(6): 46.郝玉芝, 刁建勛. 1,6二磷酸果糖佐治新生兒缺氧缺血性腦病106例[J]. 山東醫藥, 2002; 42(6): 46.
23.	Li XL, Liu P, Pan RC. Clinical effect of fructose diphosphate on patients with Hypoxic Ischemic Encephalopathy[J]. Journal of Clinical Pediatrics, 2002; 20(8): 471-472.李秀玲, 劉鵬, 潘瑞超. 1,6-二磷酸果糖治療新生兒缺氧缺血性腦病療效觀察[J]. 臨床兒科雜志, 2002; 20(8): 471～472.
24.	Wang JY. Evidence-Based Medicine and Clinical Practice[M]. 1sd edition. Beijing: Scientific Publication, 2002. 59.
25.	Moher D, Pham B, Jones A, Cook DJ, Jadad AR, Moher M. Does quality of reports of randomised trials affect estimates of intervention efficacy reported in Meta-analyses[J]. Lancet, 1998; 352: 609-613.
26.	Vickers A, Goyal N, Harland R, Rees R. Do certain countries produce only positive results? A systematic review of controlled trials[J]. Control clin trials, 1998; 19(2): 159-166.
27.	Schulz KF, Chalmers I, Hayes RJ, Altman DG. Empirical evidence of bias: dimensions of methodological quality associated with estimates of treatment effects in controlled trials[J]. JAMA, 1995; 273(5): 408-412.

1. 高瑛. 新生兒缺氧缺血性腦病的治療研究進展[J]. 臨床兒科雜志, 2004; 22(8): 568～570.
2. "九五"攻關項目HIE治療協作組.新生兒缺氧缺血性腦病治療方案(試行稿)[J]. 中國實用兒科雜志, 2000; 15(6): 381～382.
3. 李樹青, 李乃琪, 李麗, 譚華清, 徐愛晶. 1,6-二磷酸果糖治療新生兒缺氧缺血性腦病[J]. 實用兒科雜志, 1998; 13(1): 47.
4. 邵雷. 1,6-二磷酸果糖治療新生兒缺氧缺血性腦病[J]. 腦與神經疾病雜志, 1998; 6(6): 335.
5. 葉斌. 1,6-二磷酸果糖治療新生兒缺氧缺血性腦病療效觀察及預后探討[J]. 新生兒科雜志, 2000; 15(3): 114～115.
6. 卓志強, 鄭瑞霞, 施燕禧, 王素香. 果糖二磷酸鈉治療新生兒缺氧缺血性腦病療效觀察[J]. 中國醫院藥學雜志, 2000; 20(1): 19～20.
7. 況琦.1,6-二磷酸果糖治療新生兒缺氧缺血性腦病觀察[J]. 河南醫藥信息, 2001; 9(12): 10.
8. 楊康治, 陳正珊, 吳少華. 行為神經測定對1,6二磷酸果糖治療新生兒缺氧缺血性腦病的療效評價[J]. 實用醫學雜志, 2001; 17(4): 363.
9. 楊秀芬, 于清, 張春躍. 1,6-二磷酸果糖治療新生兒缺氧缺血性腦病療效觀察及預后探討[J]. 中國優生與遺傳雜志, 2001; 9(4): 76.
10. 王吉耀. 循證醫學與臨床實踐[M]. 第1版. 北京: 科學出版社, 2002. p. 59.
11. Gao Y. Progress in the research of Hypoxic Ischemic Encephalopathy treatment[J]. Journal of Clinical Pediatrics, 2004; 22(8): 568-570.
12. Ferriero, Donna M. Medical Progress: Neonatal Brain Injury[J]. New England Journal of Medicine, 2004; 351(19): 1985-1995.
13. National key scientific and technological project-Cooperation Group of HIE treatment. Pilot plan for the treatment of Hypoxic Ischemic Encephalopathy[J]. Chinese Journal of Practical Pediatrics, 2000; 15(6): 381-382.
14. Jadad AR, Moore A, Carroll D, Jenkinson C, Reynolds JM, Gavaghan DJ. Assessing the quality of reports of randomized clinical trials: Is blinding necessary[J]. Control Clin Trials, 1996; 17(1): 1-12.
15. Li SQ, Li NQ, Li L, Tan HQ, Xu AJ. 1,6-fructose diphosphate in treating of Hypoxic Ischemic Encephalopathy[J]. Journal of Practical Pediatrics, 1998; 13(1): 47.
16. Shao L. 1,6-fructose diphosphate for treatment of Hypoxic Ischemic Encephalopathy[J]. Journal of Brain and Nervous Disease, 1998; 6(6): 335.
17. Ye B. Therapeutic effects and prognosis of fructose 1,6-diphosphate in treating Hypoxic Ischemic Encephalopathy[J]. Journal of Neonatolog, 2000; 15(3): 114-115.
18. Zhuo ZQ, Zheng RX, Shi YX, Wang SX. Observation of curative effect of Fructose-1,6-Diphosphate in treating Hypoxic Ischemic Encephalopathy[J]. Journal of Hospital Pharmacy, 2000; 20(1): 19-20.
19. Kuang Q. Study of fructose-1,6-diphosphate on the treatment of Hypoxic Ischemic Encephalopathy[J]. He Nan Medical Information, 2001; 9(12): 10.
20. Yang KZ, Chen ZS, Wu SH. Evaluation the efficacy of Fructose-1,6-Diphosphate for Hypoxic Ischemic Encephalopathy with neonatal behavior neurologic assessment[J]. The Journal of Practical Medicine, 2001; 17(4): 363.
21. Yang XF, Yu Q, Zhang CY. Efficacy and prognosis of Fructose-1,6-Diphosphate on Hypoxic Ischemic Encephalopathy[J]. Chinese Journal of Birth Health and Heredity, 2001; 9(4): 76.
22. Hao YZ, Diao JX. Effect of fructose 1,6-diphosphate administration in 106 cases of Hypoxic Ischemic Encephalopathy [J]. Shandong Medical Journal, 2002; 42(6): 46.郝玉芝, 刁建勛. 1,6二磷酸果糖佐治新生兒缺氧缺血性腦病106例[J]. 山東醫藥, 2002; 42(6): 46.
23. Li XL, Liu P, Pan RC. Clinical effect of fructose diphosphate on patients with Hypoxic Ischemic Encephalopathy[J]. Journal of Clinical Pediatrics, 2002; 20(8): 471-472.李秀玲, 劉鵬, 潘瑞超. 1,6-二磷酸果糖治療新生兒缺氧缺血性腦病療效觀察[J]. 臨床兒科雜志, 2002; 20(8): 471～472.
24. Wang JY. Evidence-Based Medicine and Clinical Practice[M]. 1sd edition. Beijing: Scientific Publication, 2002. 59.
25. Moher D, Pham B, Jones A, Cook DJ, Jadad AR, Moher M. Does quality of reports of randomised trials affect estimates of intervention efficacy reported in Meta-analyses[J]. Lancet, 1998; 352: 609-613.
26. Vickers A, Goyal N, Harland R, Rees R. Do certain countries produce only positive results? A systematic review of controlled trials[J]. Control clin trials, 1998; 19(2): 159-166.
27. Schulz KF, Chalmers I, Hayes RJ, Altman DG. Empirical evidence of bias: dimensions of methodological quality associated with estimates of treatment effects in controlled trials[J]. JAMA, 1995; 273(5): 408-412.

《中國循證醫學雜志》

1,6-二磷酸果糖治療新生兒缺氧缺血性腦病的系統評價

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《中國循證醫學雜志》

1,6-二磷酸果糖治療新生兒缺氧缺血性腦病的系統評價

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