临床荟萃

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替罗非班治疗急性缺血性脑卒中的系统评价

  

  1. 河南科技大学第三附属医院(洛阳东方医院),河南 洛阳 471003
  • 出版日期:2020-05-20 发布日期:2020-04-27
  • 通讯作者: 朱晓临,Email: hkdsfy@126.com

Systematic review of tirofiban in the treatment of acute ischemic stroke

  1. Department  of  Neurology, the Third Affiliated Hospital of Henan University of Science and  Technology, Luoyang  471003,  China
  • Online:2020-05-20 Published:2020-04-27
  • Contact: Corresponding author: Zhu Xiaolin, Email : hkdsfy@126.com

摘要: 目的  通过对有关于替罗非班治疗急性缺血性脑卒中(AIS)的随机对照试验(randomized controlled trials, RCTs)临床研究文献进行系统评价,探讨其应用于AIS的有效性和安全性。方法  在Cochrane Library、EmBase、PubMed、美国科学引文索引数据库(SCI)、万方数据库(WF)、中国知网(CNKI)、中文科技期刊数据库(VIP)、中国生物医学文献数据库(CBM)等,检索出有关于替罗非班治疗AIS的所有RCTs,并进行提取相关资料。结果  纳入了15个RCT临床研究,一共纳入了1 266例患者。应用替罗非班治疗AIS治疗后,患者的NIHSS低于未应用替罗非班的对照组(MD=1.31,95%CI=1.01~1.62, I2=0%,P<0.01);亚组分析显示:治疗7 d后的NIHSS低于对照组(MD=1.39,95%CI=0.73~2.04,P<0.01);治疗14d的NIHSS低于对照组(MD=1.31,95%CI=0.96~1.66,P<0.01)。BI评分高于对照组(MD=5.74,95%CI=3.58~7.90, I2=0%,P<0.01)。mRS评分低于对照组(RR=2.09,95%CI=1.52~2.87, I2=36%,P<0.01)。ADL评分高于对照组(MD=4.26,95%CI=2.18~6.34, I2=18%,P=0.0001)。结论  替罗非班治疗AIS有利于改善患者神经功能损伤。

关键词: 替罗非班, 脑血管意外, 系统评价, Meta分析

Abstract: Objective  To systematically review about RCTs clinical studies related to tirofiban in treatment of acute ischemic stroke(AIS), and to evaluate its efficacy and safety for AIS. Methods  Databases, such as Cochrane Library, EmBase, PubMed, SCI, WF, CNKI, VIP, and CBM were searched to collect all RCTs relevant to the tirofiban in the treatment of AIS. Then, the related data were extracted from the trials. Results  A total of 15 RCT clinical studies involving 1 266  patients were selected. The meta analysis showed that NIHSS of the AIS patients treated with tirofiban was lower than that of control group which was not treated with tirofiban (MD=1.31,  95%CI=1.011.62, I2=0%, P<0.01). The subgroup analysis revealed that NIHSS was lower than that of control group after 7 days of treatment(MD=1.39,  95%CI=0.732.04, P<0.01) and the result did not change after 14 days (MD=1.31,  95%CI=0.961.66, P<0.01). The BI score was higher than that of control group (MD=5.74, 95%CI=3.587.90, I2=0%, P<0.01). The MRS score was lower than that of control group (RR=2.09, 95%CI=1.522.87, I2=36%,  P<0.01). And the ADL score was higher than that of control group (MD=4.26, 95%CI=2.186.34, I2=18%, P=0.0001). Conclusion  Tirofiban was beneficial to the improvement of neurological deficit in the treatment of AIS patients.

Key words: tirofiban, cerebrovascular accident, system review, metaanalysis