摘要
目的系统评价尤瑞克林(Urinary Kallid)治疗急性脑梗死的疗效及安全性。方法计算机检索中国生物医学文献数据库(China Biology Medicine disc,CBMdisc,1978～2010年)、中国学术期刊全文数据库(China Academic Journal,CAJ,1979～2010年)、中文科技期刊全文数据库(VIP,1989～2010年)、万方数据库(1978～2010年)等,手工检索中华神经科杂志,临床神经病学杂志、中风与神经疾病杂志、中国临床神经科学等相关杂志,收集国内关于尤瑞克林治疗急性脑梗死的随机或半随机对照试验。按Cochrane系统评价的方法,由两名研究者独立进行质量评价和资料提取,采用1%vMan5.0软件进行Meta分析。结果共纳入57篇已发表文献,包括5273例急性脑梗死患者。Meta分析结果显示:①尤瑞克林组病情恶化率低于对照组[相对危险度(relative risk,RR)=0.38,95%可信区间(confidence interval,CI)为0.27～0.52,P<0.01];②尤瑞克林组死亡率与对照组差异无统计学意义[RR=0.47,95%CI为(0.13～1.73),P=0.26];③采用Bathe指数(Barthel Index,BI)量表评定日常生活活动能力,尤瑞克林组与对照组评分差异有统计学意义[加权均数差(weighted mean difference,WMD)=7.97,95%CI(3.34～12.6),P=0.0007];④采用美国国立卫生研究院卒中量表(The National Institutes ofHealth Stroke Scale,NIHSS)评价神经功能缺损情况,尤瑞克林组与对照组评分差异有统计学意义[WMD=-2.37,95%CI(-2.95～1.79),P<0.01]。⑤尤瑞克林组不良反应发生率较对照组高,但程度轻微,不影响治疗。结论尤瑞克林可降低急性脑梗死患者病情恶化率,改善患者第14天BI及NIHSS评分情况;尤瑞克林对死亡率的影响与对照组差异无统计学意义;其不良反应发生率较对照组高,但不影响治疗。
Objective To assess the efficacy of Urinary Kallid for patients with acute cerebral infarction. Methods We searched CBMdisc （1978--2010）, CNKI （1979--2010）, VIP （1989--2010）, Wan fang Database （1978--2010） by electronic database and relevant journals such as Chinese Journal of Neurology, Journal of Clinical Neurology, Journal of Apoplexy and Nervous Diseases and Chinese Journal of Clinical Neurosciences etc. by manual searching to collect all randomized controlled trials （RCTs） and quasi-randomized controlled trials （quasi-RCTs） of Urinary Kallid for patients with acute cerebral infarction. The quality of included studies was assessed according to the criteria recommended by the Cochrane Handbook for Systematic Reviews of Interventions and data were extracted by two reviewers independently. Meta-analysis was conducted by RevMan 5.0 software. Results Fifty-seven studies involving 5273 patients were included. The results of meta-analysis showed that： t. The incidence of aggravated rate in the Urinary Kallid group was lower than that in the control group （RR-0.38, 95%CI 0.27 to 0.52, P〈0.01）; 2. There were no differences between the two groups in the incidence of mortality （RR=0.47, 95%CI 0.13 to 1.73, P=0.26）; 3. There were significant differences between the two groups in the influence of Barthel Index （BI） （WMD-7.97, 95%C1 3.34 to 12.6, P=0.0007）; 4. There were significant differences between the two groups in the influence of The National Institutes of Health Stroke Scale （NIHSS） （WMD=-2.37, 95%CI-2.95 to -1.79, P〈0.01）; 5. The incidence of adverse reaction in the Urinary Kallid group was higher than that in the control group, but the degree was slight, symptomatic treatment could make the syndromes relieving. Conclusion Urinary Kallid shows an effective reduction in the incidence of aggravated rate, it can improve BI and NIHSS. There are no differences between the two groups in the incidence of mortality, and the incidence of adverse reaction in the Urinary Kallid group is higher than that in the control group, but has no influence in treatment.
出处
《中国卒中杂志》
2011年第4期287-296,共10页
Chinese Journal of Stroke
关键词
脑梗死
尤瑞克林
随机对照试验
META分析
Brain infarction
Urinary Kallid
Randomized controlled trial
Meta-analysis
