重组组织型纤溶酶原激活剂静脉溶栓治疗急性缺血性脑卒中疗效及安全性的Meta分析

发布时间：2019-07-06 17:05

【摘要】：目的：系统评价重组组织型纤溶酶原激活剂(rt-PA)治疗急性缺血性脑卒中的疗效及安全性。方法：检索Cochrane图书馆(2013年第3期)、PubMed、EMbase数据库、中国生物医学文献数据库、中国学术期刊网全文数据库,收集rt-PA或安慰剂治疗急性缺血性脑卒中的随机或非随机对照试验,检索时间为1995年1月-2013年6月。两名评价者按照纳入与排除标准选择试验、提取资料和评价质量后,采用RevMan5.0软件进行Meta分析。结果：纳入7个随机对照试验(RCT),共6548例患者。Meta分析结果显示：rt-PA组治疗急性缺血性脑卒中的3-6个月有利神经评分[RR=1.22,95%CI(1.10,1.35),P=0.0002]高于安慰剂组；rt-PA在0-3h时间窗[RR=1.53,95%CI(1.32,1.78),P0.0001]、3-4.5h时间窗[RR=1.13,95%CI(1.02,1.25),P=0.02]有利神经评分均优于安慰剂组,4.5-6h时间窗rt-PA组较安慰剂组无统计学差异。rt-PA组的症状性颅内出血发生率[RR=3.94,95%CI(2.31,6.70),P0.00001]高于安慰剂组,但两组的3-6个月总体死亡率无统计学差异。结论：rt-PA组治疗急性缺血性脑卒中较安慰剂组能获得更好的有利神经评分,在0-4.5h时间窗内优于安慰剂组,但在4.5-6h时间窗,两组的有利神经评分并无差别。rt-PA组较安慰剂组溶栓后症状性颅内出血发生率更高,两组的3-6个月总体死亡率无明显差异。由于纳入研究数量有限,.本研究结果尚需更多高质量的随机对照试验进一步证实。
[Abstract]:Objective: to systematically evaluate the efficacy and safety of recombinant tissue type PA (rt-PA) in the treatment of acute ischemic stroke. Methods: the Cochrane Library (No. 3, 2013), the PubMed,EMbase Database, the Chinese Biomedical Literature Database and the full-text Database of the Chinese academic Journal Network were searched. Random or non-randomized controlled trials of rt-PA or placebo in the treatment of acute ischemic stroke were collected. The retrieval time was from January 1995 to June 2013. According to the inclusion and exclusion criteria, the two evaluators selected the test, extracted the data and evaluated the quality, and used RevMan5.0 software for Meta analysis. Results: a total of 6548 patients with (RCT), were included in 7 randomized controlled trials. Meta-analysis showed that the favorable nerve score [RR=1.22,95%CI (1.10, 1.35), P 鈮，

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