背景:医学排斥疗法在接受保守干预的患者中显示出治疗输尿管结石的功效。这项荟萃分析旨在评估米拉贝隆治疗输尿管结石的有效性。方法:从概念到2023年11月,我们检查了PubMed数据库,Cochrane图书馆,Embase,奥维德,Scopus,以及本系统评价和荟萃分析的试验注册中心。我们选择了相关的随机对照试验(RCT),以评估米拉贝隆作为输尿管结石的排骨治疗的疗效。使用Cochrane偏倚风险方法评估证据质量。成果措施,其中包括结石排出率(SER),驱逐时间,和疼痛发作,使用RevMan5.4和Stata17进行分析。结果:7个RCT(N=701)具有足够的信息并最终被纳入。在输尿管结石患者中,米拉贝隆治疗的患者的SER[比值比(OR)=2.57,95%置信区间(CI)=1.41~4.68,p=0.002]显著高于安慰剂治疗的患者.亚组分析显示,在输尿管小结石患者中,mirabegron优于安慰剂(OR=2.26,95%CI=1.05-4.87,p=0.04),研究之间没有异质性(p=0.54;I2=0%)。Mirabegron患者的输尿管远端结石(DUSs)的SER高于对照组(OR=2.48,95%CI=1.31-4.68,p=0.005)。然而,两组间结石排出时间或疼痛发作无差异.结论:Mirabegron可显著改善输尿管结石患者的SER,对于小型和DUSS,效果似乎更明显。然而,Mirabegron治疗与改善结石排出时间或疼痛管理无关.
Background: Medical expulsive therapy demonstrates efficacy in managing ureteral stones in patients amenable to conservative interventions. This meta-analysis aims to evaluate the effectiveness of mirabegron in the treatment of ureteral stones. Methods: From conception to November 2023, we examined PubMed databases, the Cochrane Library, Embase, Ovid, Scopus, and trial registries for this systematic
review and meta-analysis. We chose relevant randomized controlled trials (RCTs) evaluating the efficacy of mirabegron as an expulsive treatment for ureteral stones. The Cochrane risk of bias method was used to assess the quality of the evidence. Outcome measures, which included the stone expulsion rate (SER), expulsion time, and pain episodes, were analyzed using RevMan 5.4 and Stata 17. Results: Seven RCTs (N = 701) had enough information and were ultimately included. In patients with ureteral stones, mirabegron-treated patients had a substantially higher SER [odds ratio (OR) = 2.57, 95% confidence interval (CI) = 1.41-4.68, p = 0.002] than placebo-treated patients. Subgroup analysis revealed that mirabegron was superior to placebo in patients with small ureteral stones (OR = 2.26, 95% CI = 1.05-4.87, p = 0.04), with no heterogeneity between studies (p = 0.54; I2 = 0%). Mirabegron patients had a higher SER than the control group for distal ureteral stones (DUSs) (OR = 2.48, 95% CI = 1.31-4.68, p = 0.005). However, there was no difference in stone ejection time or pain episodes between groups. Conclusion: Mirabegron considerably improves SER in patients with ureteral stones, and the effect appears to be more pronounced for small and DUSs. Nevertheless, mirabegron treatment was not associated with improved stone expulsion time or pain management.