不同低剂量替格瑞洛联合阿司匹林治疗急、慢性冠心病的研究进展

目的 系统评价布地奈德不同给药方式联用肺表面活性剂治疗新生儿呼吸窘迫综合征（neonatal respiratory distresssyndrome，NRDS）的临床疗效和安全性。方法 计算机检索中国学术期刊全文数据库（CNKI）、万方数据知识服务平台（Wanfang Data）、维普期刊中文数据库（VIP）、中国生物医学文献数据库（CBM）、PubMed、EMBase、the CochranceLibrary数据库，收集从建库至2021年2月发表的布地奈德持续吸入、单剂吸入和气管滴入分别联用肺表面活性剂治疗NRDS的临床对照研究。提取符合纳入标准的文献并进行质量评价，运用RevMan 5.3软件进行Meta分析。结果 共纳入10篇文献，1 049例患者，持续吸入组400例，单剂吸入组265例，气管滴入组384例。Meta分析结果显示：布地奈德持续吸入组治疗后氧合指数增加值大于气管滴入组和单剂吸入组，中重度支气管肺发育不良（BPD）发生率、辅助通气时间、有创机械通气率和肺表面活性剂反复使用率小于气管滴入组和单剂吸入组；气管滴入组治疗后增加值大于单剂吸入组，中重度BPD发生率、辅助通气时间、有创机械通气率和肺表面活性剂反复使用率小于单剂吸入组，差异均有统计学意义（P<0.05）。结论 布地奈德不同用药方式联用肺表面活性剂治疗NRDS的临床疗效存在一定差异，持续雾化吸入给药是最优用药方案，其次为气管滴入给药，再次为单剂雾化吸入。

Research progress of low-dose ticagrelor combined with aspirin for acute and stable coronary heart disease

Objective To systematically evaluate the the efficacy of different administration of budesonide combined with pulmonary surfactant (PS) in the treatment of neonatal respiratory distress syndrome (NRDS). Methods The CNKI, Wanfang database, VIP database, CBM, PubMed, EMBase, The Cochrance Library were retrieved to collect the randomized controlled trials of budesonide continuous inhalation, single inhalation and tracheal instillation combined with Surfactant in the treatment of NRDS. According to inclusion and exclusion criteria, qualified literature was screened for evaluation, data was extracted and Meta-analysis was performed with RevMan 5.3 software. Results A total of 10 related studies were collected, including 1 049 children, and 400 cases in continuous inhalation group, 265 cases in single inhalation group and 384 cases in tracheal instillation group.The results of Meta-analysis showed that the increase of oxygenation index (OI) in the continuous inhalation group was highest than that in the tracheal instillation group and the single inhalation group, the incidence of moderate and severe BPD, the time of auxiliary ventilation, the rate of invasive mechanical ventilation and the rate of repeated use of PS were lowest than those in the tracheal instillation group and the single inhalation group, and the increase of OI in the tracheal instillation group was higher than that in the single inhalation group, the incidence of moderate and severe BPD, the time of auxiliary ventilation, the rate of invasive mechanical ventilation and the rate of repeated use of PS were lower than those in the single inhalation group, all the differences were statistically significant (P < 0.05). Conclusion The clinical effect of different administration of budesonide combined with PS in the treatment of NRDS are different, continuous inhalation group of budesonide combined with PS is the best scheme, the second is tracheal instillation, and the third is single inhalation.