产后利尿剂治疗妊娠高血压疾病:系统性审查和元分析
Emma Trawick Roberts1, Johanna Quist-Nelson, Elana Jaffe Brotkin
1Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, and the Duke University School of Medicine, Durham, North Carolina; the Delaware Center of Maternal-Fetal Medicine for ChristianaCare, Newark, Delaware; and the Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at UTHealth Houston, Houston, Texas.
Obstetrics and gynecology
|August 14, 2025
概括
利尿剂可以降低与怀孕相关的高血压疾病的妇女的产后立即高血压,治疗所需的数量为4. 然而,在高质量的试验中,这种益处并不显著,这表明需要进一步研究.
科学领域:
- 产科和妇科 产科和妇科
- 药理学 药理学是指药理学的学科.
- 心血管医学 心血管医学
背景情况:
- 妊娠高血压疾病 (HDP) 是孕产妇发病率的重要原因之一.
- 对产后高血压的有效管理对于母亲的结果至关重要.
- 利尿剂通常被认为用于控制液体平衡和血压.
研究的目的:
- 系统地审查利尿剂在降低产后高血压方面的疗效.
- 评估利尿剂对孕产妇发病率和其他产后并发症的影响.
主要方法:
- 进行了随机对照试验 (RCT) 的系统审查和元分析.
- 搜索包括 MEDLINE,EMBASE,CINAHL 和 Cochrane 中央受控试验登记册,截至 2024 年 6 月.
- 包含的RCT每组有≥20名参与者,重点关注HDP的产后利尿剂使用.
主要成果:
- 纳入了10个RCT (1,815人),其中包括furosemide和torsemide等干预措施.
- 利尿剂的使用与2周内降低产后高血压有关 (NNT=4).
- 在血压,严重的孕产妇发病率或再入院方面没有发现显著差异;在偏差风险低的试验中,高血压的降低并不显著.
结论:
- 利尿剂在HDP中显示出与降低直接产后高血压的潜在关联.
- 当仅考虑高质量的研究时,观察到的益处并不强大.
- 需要进一步的研究来澄清利尿剂在治疗产后高血压中的作用.
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