长春西汀联合依达拉奉治疗脑梗死的系统评价房秀梅王芳解放军总.docVIP

长春西汀联合依达拉奉治疗脑梗死的系统评价 房秀梅, 王芳(解放军总医院第一附属医院药剂药理科，北京) 摘要 目的 系统评价长春西汀联合依达拉奉治疗脑梗死的疗效及安全性。方法 计算机检索PubMed、EMBase、CNKI、WanFang Data，收集长春西汀联合依达拉奉治疗脑梗死的随机对照试验。检索时限均为2000-2014年。按照事先制定的纳入排除标准筛选文献、提取资料和评价质量后，采用RevMan 5.1 软件进行Meta分析。结果 共纳入10个随机对照试验，合计739例患者。其中，治疗组372例，对照组367例。各纳入研究基线资料具有可比性，均报道采用随机方法，所有研究均未提及盲法和分配隐藏情况。Meta分析结果显示：长春西汀联合依达拉奉在治疗脑梗死有效率方面与对照组比较，其差异具有统计学意义[OR=3.57，95%CI(2.30，5.56) ，P＜0.00001]；长春西汀联合依达拉奉在治疗脑梗死神经功能缺损方面与对照组比较，其差异也有统计学意义[WMD=-5.51,95%CI（-8.64,-2.38），P=0.00006]；此外，长春西汀联合依达拉奉治疗脑梗死在不良反应发生率方面与对照组比较差异无统计学意义 [OR=2.26，95%CI(0.82，6.22) ，P=0.12]。结论 本系统评价结果显示，长春西汀联合依达拉奉治疗脑梗死疗效显著，且对神经功能有良好改善作用。但由于本系统评价纳入研究的质量较低，存在偏倚的可能性，影响了结果的论证强度，因此上述结论应谨慎对待，并期待更多高质量的随机双盲对照试验以提供更高质量的证据。 关键词 依达拉奉；长春西汀；脑梗死；系统评价；Meta Abstract Objective To assess the effectiveness and safety of vinpocetine combined with edaravone for cerebral infarction. Methods Such databases as PubMed(2000 to 2014),EMBase(2000 to 2014),CNKI(2000 to 2014),WanFang Data(2000 to 2014) were searched to collect randomized controlled trials(RCTs) of vinpocetine combined with control group for cerebral infarction.Then the retrieved studies were screened according to the predefined inclusion and exclusion criteria,the date were extracted,the quality of the included studies was evaluated,and meta-analyses were performed by using the Cochrane Collaboration’s RevMan 5.1 software.Results A total of 10 RCTs involving 739 cases were involved,among which 372 cases were in the treatment group and the other 367 were in the control group.All studies with comparable baseline data reported the application of random methods without explaining the detailed methods,the blinding method and the allocation concealment.The results of meta-analyses indicated that vinpocetine combined with control group had significant differences in the effective rate for cerebral infarction compared with control group [OR=3.57,95%CI(2.30,5.56),P＜0.00001],and it had significant differences in treating the defect of neurological function compared with c