METHODS: We searched MEDLINE, Cochrane CENTRAL, and Embase for both observational studies and randomized controlled trials (RCTs) investigating the effectiveness of EPO in treating NE. Only studies in which at least 300 U/kg of EPO was used and reported any one of the following outcomes: death, death or neurodisability, and cerebral palsy, were included.
RESULTS: Seven studies with 903 infants with the diagnosis of NE were included in our meta-analysis. EPO did not reduce the risk of death or neurodisability (risk ratio 0.68 [95% confidence interval [CI]: 0.43 to 1.09]) (P = 0.11). Similarly, the risk of cerebral palsy was not reduced by the administration of EPO (risk ratio 0.68 [95% CI: 0.33 to 1.40]) (P = 0.30). The risk of death was also not reduced at any dose of EPO regardless of the use of TH.
CONCLUSIONS: The results of our meta-analysis do not support the use of EPO for the treatment of neonatal encephalopathy. However, future large-scale RCTs are needed to strengthen these findings.
方法:我们搜索了MEDLINE,科克伦中部,和Embase用于观察性研究和随机对照试验(RCTs),研究EPO治疗NE的有效性。仅使用至少300U/kgEPO并报告以下任何一种结果的研究:死亡,死亡或神经残疾,和脑瘫,包括在内。
结果:我们的荟萃分析中纳入了7项研究,包含903名诊断为NE的婴儿。EPO没有降低死亡或神经残疾的风险(风险比0.68[95%置信区间[CI]:0.43至1.09])(P=0.11)。同样,服用EPO并未降低脑瘫的风险(风险比0.68[95%CI:0.33~1.40])(P=0.30).无论使用哪种剂量的EPO,死亡风险也没有降低。
结论:我们的荟萃分析结果不支持使用EPO治疗新生儿脑病。然而,未来需要大规模RCT来加强这些发现.