摘要：

目的：通过系统综述及Meta分析比较局部外用噻吗洛尔与口服普萘洛尔治疗表浅型婴幼儿血管瘤的疗效及副作用的发生率，评估外用噻吗洛尔能否成为表浅型婴幼儿血管瘤的一线用药。方法：在多个中英文数据库中搜索关于局部外用噻吗洛尔及口服普萘洛尔治疗婴幼儿血管瘤的对比研究。根据研究目的选取效应量，先进行异质性检验，再进行Meta分析，应用漏斗图等评估发表偏倚。结果：共计纳入8篇临床研究进行Meta分析。结果显示，局部外用噻吗洛尔治疗婴幼儿血管瘤的疗效显著优于口服普萘洛尔[RR=1.15，95%CI（1.01，1.30），P=0.04]，而全身不良反应发生率相比口服普萘洛尔组明显降低[RR=0.26，95%CI（0.17，0.40），P<0.000 01]，差异均有统计学意义。漏斗图等显示本文所纳入的文献无明显发表偏倚。结论：局部外用噻吗洛尔治疗表浅型婴幼儿血管瘤，其总体有效率明显高于口服普萘洛尔组，且全身不良反应的发生率明显低于后者。

关键词: 噻吗洛尔, 普萘洛尔, 婴幼儿血管瘤, Meta分析

Abstract:

Objective: Through systematic reviews and Meta-analyses, the efficacy and side effects of topical timolol and oral use propranolol in the treatment of superficial infantile hemangioma were compared, and the therapeutic effect of topical timolol on this disease was further evaluated to guide the clinical rational administration of medication. Methods: A comparative study of timolol and propranolol in the treatment of infantile hemangioma was searched in both Chinese and English databases diversely. According to the results of heterogeneity test, fixed effect model was selected for Meta-analysis, and publication bias was assessed by funnel plot etc. Results: A total of 8 clinical studies were included for Meta-analysis. The results showed that, compared with oral use propranolol, topical timolol is significantly better in the treatment of infantile hemangiomas (RR=1.15, 95%CI [1.01, 1.30], P=0.04). However, its incidence of systemic adverse reactions was significantly lower than the oral use propranolol group, with an RR value of 0.26, 95%CI(0.17,0.40), P<0.000 01. All differences between these two kinds of therapeutic regimen were statistically significant. Funnel plot displayed that the articles included in this paper have no obvious publication bias. Conclusion: The overall effective rate of timolol group was significantly higher than that of propranolol group, and the incidence of systemic adverse reactions was significantly lower than that of propranolol group.

Key words: timolol, propranolol, infantile hemangiomas, Meta-analysis

中图分类号: 

• R782