| Background Neonatal hypoxic-ischemic encephalopathy(hypoxic ischemic encephalopathy,HIE)refers to partial or complete hypoxic-ischemic damage caused by perinatal hypoxic asphyxia,which is the main cause of neonatal death and long-term sequelae.In China,nerve growth factor has been-widely used in the treatment of neonatal hypoxic-ischemic encephalopathy,but its clinical efficacy and safety are still unclear.Objective To evaluate the efficacy and safety of nerve growth factor in the treatment of neonatal hypoxic-ischemic encephalopathy.Methods A comprehensive iterature research was performed by computer in database including Chinese Journals Full-text Database(CNKI),VIP Chinese science and technology periodical database,Wanfang database,China Biomedical Literature Service system,PubMed,Cochrane library and Web of science.Randomized controlled trials and semi-randomized controlled trials with nerve growth factor as intervention in the treatment of neonatal hypoxic-ischemic encephalopathy were collected.The time range of literature retrieval is from the establishment of the database to November 2019.The literature was screened and extracted according to the inclusion and exclusion criteria,the quality of the literature was evaluated by the research method of Cochrane collaboration network,and the RevMan5.3 software provided by Cochrane collaboration network was used for statistical analysis.Result A total of 26 articles were included,including 2129 case of children.The result of Meta analysis show that:(1)In terms of clinical effective rate[OR=1.27(95%CI:1.22-1.34),P<0.00001],the difference was statistically significant,and the clinical effective rate of nerve growth factor group was higher;(2)In terms of improving the neonatal behavioral neurological assessment,there were significant statistically differences on the 7th day[successive medication groupWMD=4.16(95%CI:3.62-4.70),P<0.00001)],the 14th day[WMD=4.20(95%CI:3.91-4.50),P<0.00001),and the 28th day[WMD=1.40(95%CI:0.92-1.89),P<0.00001)],the nerve growth factor treatment group was better than the control group.But in 7th day[alternate day therapy groupWMD=0.16(95%CI:-0.11-0.43),P=0.243]and 14th days change of neonatal behavioral neurological assessment before and after treatment[WMD=2.26(95%CI:0.05-4.48),paired 0.05],there was no statistically significant difference between two methods.(3)In terms of improving the mental developmental index i(MDI),there were significant statistically differences in NGF treatment group at 3 months[WMD=7.85(95%CI:5.14-10.56),P<0.00001],6 months[WMD=7.27(95%CI:4.22-10.33),P<0.00001],10 months[WMD=7.72(95%CI:3.12-12.31),P=0.0010].The nerve growth factor treatment group was better than the control group.(4)In terms of improving psychomotor development index(PDI),there were significant differences in NGF treatment group at 3 months[WMD=8.13(95%CI:5.07-11.20),P<0.00001)],6 months[WMD=8.65(95%CI:5.97-11.32),P<0.00001],10 months[WMD=7.45(95%CI:2.18-12.72),P=0.006].The effect of nerve growth factor group was better than that of control group.(4)In terms of improving clinical symptoms,the time spent in the recovery of muscle tone in the nerve growth factor treatment group[WMD=-2.38(95%CI:-2.55-2.22),P<0.00001],the time of convulsion regression[WMD=-2.38(95%CI:-3.09--1..67),P<0.00001)],the time of consciousness recovery[WMD=-2.38(95%CI:-2.93--1.84),P<0.00001)]and the time of primordial reflex recovery[WMD=-2.59(95%CI:-3.13--2.05),P<0.00001])were less,the difference was statistically significant.Conclusion The present Meta analysis showed that nerve growth factor has a good clinical effec in the treatment of neonatal hypoxic-ischemic encephalopathy,it can also improve neonatal neurobehavioral score,promote intellectual and motor development and shorten the course of disease.Due to the quality restrictions included in the study,high-quality clinical randomized controlled trials are still needed to confirm this conclusion. |
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