Effects comparison of Poractant Alfa Injection and ambroxol hydrochloride in treating neonatal respiratory distress syndrome :a Meta analysis / 重庆医学

ABSTRACT

Objective To systematically assess the clinical effect and safety of Poractant Alfa Injection and ambroxol hydro-chloride in treating neonatal respiratory distress syndrome (NRDS) .Methods The home and abroad randomized controlled trials ( RCTs ) on the comparison of clinical effect and safety of Poractant Alfa Injection and ambroxol hydrochloride in treating NRDS were retrieved by computer .The literature quality was evaluated by the modified JADAD scale .Rev Man5 .3 .1 software was used for conducting the meta analysis .Results Twenty-four RCT were included .The meta analysis results showed that compared with ambroxol hydrochloride ,Poractant Alfa Injection for treating NRDS could more significantly increase the PH value (MD= -0 .02 , 95% CI-0 .03- -0 .01 ,P<0 .01) ,increased the PaO2 value(MD= -2 .92 ,95% CI-4 .59 - -1 .26 ,P<0 .01) ,decreased the PaCO2 value (MD=0 .95 ,95% CI0 .12-1 .77 ,P=0 .02) ,reduced the FiO2 value(MD=0 .03 ,95% CI0 .01-0 .05 ,P<0 .01) ,en-hanced the Pa O2/FiO2 ratio (MD= -7 .62 ,95% CI-10 .87 - -4 .37 ,P<0 .01) ,reduced the short term complications (RR=1 .67 ,95% CI1 .31-2 .12 ,P<0 .01) and long-term complications (RR=2 .85 ,95% CI1 .14-7 .07 ,P=0 .02) ,shortened the hos-pitalization days (RR=3 .03 ,95% CI0 .94 -5 .11 ,P<0 .01) as well as decreased the mortality rate (RR=1 .96 ,95% CI1 .15-3 .34 ,P=0 .01) .However ,there were no statistical differences in the durations of continuous positive airway pressure (CPAP) me-chanical ventilation ,oxygen inhalation time ,time of clinical symptom outcome ,incidence rate of NRDS and total effective rate of treatment between the two groups .Conclusion Currently published evidences show that Poractant Alfa Injection is superior to am-broxol hydrochloride in treating NRDS ,however ,due to limited number of included RCD and medium quality ,the conclusion needs large scale and multicenter RCT verification .