Effects and Safety of Magnesium Sulfate on Neuroprotection: A Meta-analysis Based on PRISMA Guidelines

To evaluate the evidence of effects and safety of magnesium sulfate on neuroprotection for preterm infants who had exposure in uteri.We searched electronic databases and bibliographies of relevant papers to identify studies comparing magnesium sulfate (MgSO₄) with placebo or other treatments in patients at high risk of preterm labor and reporting effects and safety of MgSO₄ for antenatal infants. Then, we did this meta-analysis based on PRISMA guideline. The primary outcomes included fatal death, cerebral palsy (CP), intraventricular hemorrhage, and periventricular leukomalacia. Secondary outcomes included various neonatal and maternal outcomes.Ten studies including 6 randomized controlled trials and 5 cohort studies, and involving 18,655 preterm infants were analyzed. For the rate of moderate to severe CP, MgSO₄ showed the ability to reduce the risk and achieved statistically significant difference (odd ratio [OR] 0.61, 95% confidence interval [CI] 0.42–0.89, P = 0.01). The comparison of mortality rate between the MgSO4 group and the placebo group only presented small difference clinically, but reached no statistical significance (OR 0.92, 95% CI 0.77–1.11, P = 0.39). Summarily, the analysis of adverse effects on babies showed no margin (P > 0.05). Yet for mothers, MgSO₄ exhibited obvious side-effects, such as respiratory depression, nausea and so forth, but there exited great heterogeneity.MgSO₄ administered to women at high risk of preterm labor could reduce the risk of moderate to severe CP, without obvious adverse effects on babies. Although there exit many unfavorable effects on mothers, yet they may be lessened through reduction of the dose of MgSO₄ and could be tolerable for mothers. So MgSO₄ is both beneficial and safety to be used as a neuroprotective agent for premature infants before a valid alternative was discovered.     

他汀类药物治疗AECOPD的临床研究

目的探讨他汀类药物在慢性阻塞性肺疾病急性加重期(Acute exacerbation of chronic obstructive pulmonary disease,AECOPD)治疗中的临床意义。方法选取39例AECOPD患者,随机分为2组。对照组20例,给予常规治疗;治疗组19例,在常规治疗基础上加用辛伐他汀20 mg,每晚1次。两组均连续治疗10 d。观察两组患者治疗前后血气分析、肺功能、肺动脉压、hs-CRP、纤维蛋白原等。结果治疗组患者的第1秒用力呼气量占预计值百分比(FEV1%pred)改善,平均肺动脉压降低,血氧分压提高,hs-CRP、纤维蛋白原、SGRQ评分比对照组降低明显(P<0.05)。结论他汀类药物应用于临床治疗AECOPD能减轻炎症反应,提高氧分压,改善患者的肺功能,降低肺动脉压,减少血栓事件的风险,提高生活质量。