脑卒中早期降压疗效与安全性的系统评价

发布时间：2018-06-05 06:41

  本文选题：脑卒中 + 早期降压　； 参考：《广西医科大学》2014年硕士论文

【摘要】：背景：尽管控制高血压在脑卒中的一级和二级预防获益很明确，但是脑卒中后早期降压的获益及安全性仍不明确。 目的:评估脑卒中早期降压是否能改善临床结局。 方法：计算机检索Medline、Embase、Cochrane Library、相关期刊论文（CNKI）、维普中文科技期刊数据库及万方数据库;同时手工检索国内相关领域杂志。纳入研究为脑卒中后早期是否降压的随机对照试验，结局指标是死亡/残疾人数及不良事件数。使用Review Manager5.1.4软件对所提取的数据进行统计分析，卡方检验与I2评价异质性，采用相对危险度、95%可信区间、p值描述结果。 结果：总共纳入8篇随机对照试验文献，试验组5191例患者，，对照组5166例患者。荟萃分析结果表明：14d的死亡/残疾结果比较中，降压组与对照组死亡/残疾发生率差异无统计学意义[P=0.75，RR=1.01，95%CI：（0.94,1.09）]。在3m的死亡/残疾结果比较中，共纳入了7,255例患者，降压组与对照组死亡/残疾发生率差异无统计学意义[P=0.23，RR=0.97，95%CI：（0.91,1.02）]。并以年龄＜65y、年龄≥65y、有高血压病史、无高血压病史、血压＜180mmHg、血压≥180mmHg进行亚组分析，结果提示3m的死亡/残疾率差异无统计学意义。在6m的死亡/残疾结果比较中，共纳入了2,792例患者，结果提示降压组与对照组死亡/残疾率差异无统计学意义[P=0.47，RR=1.04，95%CI：（0.94,1.15）]。3m内不良事件的结果比较中，共纳入了3,272例患者，结果提示降压组与对照组脑卒中发生不良事件发生率差异无统计学意义[P=0.90，RR=1.01，95%CI：（0.89,1.14）]。 结论：目前尚无足够证据表明脑卒中后早期降压能改善或者加重临床结局，积极降压与不降压安全性相当。
[Abstract]:Background: although the benefits of primary and secondary prevention of hypertension control in stroke are clear, the benefits and safety of early hypotension after stroke are unclear. Objective: to evaluate whether early hypotension of stroke can improve the clinical outcome. Methods: Medlinean Embase Cochrane Library, CNKI, Weipu Chinese Science and Technology Journal Database and Wanfang Database were searched by computer, and related domestic journals were searched by hand at the same time. In a randomized controlled trial of early poststroke hypotension, death / disability and adverse events were the outcome indicators. The extracted data were statistically analyzed by Review Manager5.1.4 software. The heterogeneity was evaluated by chi-square test and I2. The results were described by 95% confidence interval of relative risk. Results: a total of 8 articles of randomized controlled trials were included, 5191 patients in the trial group and 5166 patients in the control group. The results of meta-analysis showed that there was no significant difference in mortality / disability rate between the hypotensive group and the control group in the death / disability outcome of 14 days (P < 0. 75). 7255 patients were included in this study. There was no significant difference in the incidence of death / disability between the hypotensive group and the control group. Age < 65yand age 鈮

本文编号：1981017