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目的:分析低剂量(125~250mg)乙酰唑胺(Acetazolamide)预防高海拔头痛(HAH)的效果。方法:采用计算机检索Medline、PubMed、Springer、Elsevier、LWW等文献数据库,收集2012年12月前国外公开发表的乙酰唑胺预防HAH或急性高原病(AMS)的文献,运用Rvn 5软件进行Meta分析。结果:共纳入低剂量乙酰唑胺预防HAH或AMS的文献7篇,累计服用乙酰唑胺组(观察组)518例,安慰剂组(对照组)447例。采用固定效应模型计算,加权均方差(WMD)为0.48,95%CI为0.41~0.57,对WMD的检验结果为Z=8.26(P<0.01);观察组HAH发生率显著低于对照组(P<0.05)。结论:低剂量的乙酰唑胺能有效降低HAH发生率,高海拔暴露前服用乙酰唑胺有助于预防HAH;但不同海拔高度及不同攀升方式或速度,预防效果存在差异。
Objective: To analyze the effect of low dose (125 ~ 250mg) Acetazolamide in preventing high altitude headache (HAH). METHODS: Literature databases such as Medline, PubMed, Springer, Elsevier and LWW were searched by computer to collect the literature of acetazolamide prevention HAH or Acute Altiplano (AMS) before December 2012. Meta-analysis was conducted by Rvn 5 software . Results: A total of 7 articles on low dose of acetazolamide for the prevention of HAH or AMS were included. A total of 518 cases of acetazolamide (observation group) and 447 cases of placebo (control group) were taken. The fixed-effect model was used to calculate the weighted mean square error (WMD) of 0.48, the 95% CI of 0.41-0.57 and the WMD test result of Z = 8.26 (P <0.01). The incidence of HAH in the observation group was significantly lower than that in the control group <0.05). CONCLUSION: Low dose of acetazolamide can effectively reduce the incidence of HAH. Administration of acetazolamide before high altitude exposure may be helpful to prevent HAH. However, the effect of prevention is different at different altitude and different climbing methods or speed.