巴曲酶治疗急性缺血性脑卒中临床疗效的Meta分析

发布时间：2018-10-29 12:16

【摘要】：目的评价应用不同剂量范围巴曲酶(20 BU、40 BU、50 BU)治疗不同程度缺血性脑卒中的有效性、安全性以及合理性,以期为其临床应用提供基于循证医学方面的可靠参考。方法计算机检索Pub Med、EMbase、Cochrane Library、CNKI、VIP、Wan Fang Data、CSCD及临床试验注册库。人工检索相关杂志、内部报告和会议论文,联系有关文献作者或专家获得未发表的文献质料。所有检索时间均从建库至2015年8月1日。采用Cochrane风险偏倚评估工具评价分析收集到的文献质量。采用Reviews Manager 5.3对最后纳入的文献进行Meta分析。结果(1)巴曲酶比常规治疗更能有效的降低治疗后3个月时的死亡及残疾率,但无统计学意义(P0.05);(2)大剂量40 BU巴曲酶组治疗后20 d时的神经功能缺损评分的总显效率优于20 BU巴曲酶治疗组,且有统计学意义(P0.01);(3)大剂量40 BU巴曲酶组治疗后1周及2周后ESS评分均优于20 BU巴曲酶治疗组,且有统计学意义(P均0.01);(4)大剂量50 BU巴曲酶组治疗后2周时的神经功能缺损评分优于20 BU巴曲酶治疗组,且有统计学意义(P0.05);(5)在重型脑梗死治疗方面大剂量50 BU巴曲酶组治疗后2周时的神经功能缺损评分优于常规治疗组,且有统计学意义(P0.05);(6)急性进展性脑梗死治疗方面20 BU巴曲酶组治疗后2周时的神经功能缺损评分的总有效率优于常规治疗组,且有统计学意义(P0.01);(7)在脑梗死发病24 h内、24~48 h二个时间段巴曲酶治疗组的总显效率均优于常规治疗组,有统计学意义(P均0.01),48~72 h巴曲酶治疗组的总显效率优于常规治疗组,但无统计学意义(P0.05),提示开始使用巴曲酶的时间越早,效果越显著。结论不同剂量范围巴曲酶(20 BU、40 BU、50 BU)是急性缺血性脑卒中患者的安全、有效的治疗方法。
[Abstract]:Objective to evaluate the efficacy, safety and rationality of different doses of batroxobin (20 BU,40 BU,50 BU) in the treatment of ischemic stroke of different degrees, so as to provide a reliable reference for its clinical application based on evidence-based medicine. Methods Pub Med,EMbase,Cochrane Library,CNKI,VIP,Wan Fang Data,CSCD and clinical trial registry were searched by computer. Manually search related journals, internal reports and conference papers, contact the authors or experts to obtain unpublished materials. All retrieval time is from the construction of the database to August 1, 2015. Cochrane risk bias assessment tool was used to evaluate the quality of literature collected. Reviews Manager 5.3 was used to analyze the last included literature by Meta. Results (1) Batroxobin was more effective than conventional therapy in reducing the death and disability rate at 3 months after treatment, but there was no statistical significance (P0.05). (2) the total effective rate of the high dose 40 BU batroxobin group 20 days after treatment was better than that of the 20 BU batroxobin group (P0.01). (3) the ESS score in the 40 BU batroxobin group was significantly higher than that in the 20 BU batroxobin group at 1 week and 2 weeks after treatment (all P 0.01). (4) the neurological impairment score in the 50 BU batroxobin group was better than that in the 20 BU batroxobin group 2 weeks after treatment (P0.05). (5) in the treatment of severe cerebral infarction, the neurological deficit score in the 50 BU batroxobin group was better than that in the routine treatment group 2 weeks after treatment (P0.05); (6) in the treatment of acute progressive cerebral infarction, the total effective rate of the 20 BU batroxobin group was better than that of the routine treatment group at 2 weeks after treatment (P0.01). (7) within 24 h after the onset of cerebral infarction, the total effective rate of batroxobin treatment group was better than that of routine treatment group at 24 ~ 48 h (P 0.01), and the total effective rate in 4872 h batroxobin group was better than that in routine treatment group. However, there was no statistical significance (P0.05), suggesting that the earlier the time to start using batroxobin, the more significant the effect. Conclusion Batroxobin (20 BU,40 BU,50 BU) is a safe and effective treatment for acute ischemic stroke.
【作者单位】：河南科技大学临床医学院;河南科技大学第一附属医院;
【分类号】：R743.3

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