依达拉奉对急性脑外伤患者生存的影响

Effectiveness of Edaravone for Survival of Patients with Acute Cerebral Trauma:A Meta-Analysis of Seven Domestic Studies

目的用Meta分析(Meta-analysis)的方法对国内已发表的有关比较常规治疗方法联合依达拉奉和常规治疗方法对急性脑外伤患者生存期影响的临床研究进行综合定量分析,为急性脑外伤患者处理模式的选择提供参考依据。方法收集已公开发表的有关比较常规治疗方法联合依达拉奉和常规治疗方法对急性脑外伤患者生存期影响的所有随访严密的临床研究。按分析的要求对检索到的原始研究的质量进行评估,对符合条件的所有研究结果进行Meta分析,计算常规治疗方法联合依达拉奉和常规治疗方法死亡危险的优势比(odds ratio,OR),评价常规治疗方法联合依达拉奉和常规治疗方法对患者生存期的影响。结果符合纳入标准的共7篇文献,总样本量427例。其中,常规治疗方法联合依达拉奉219例,死亡47例;常规治疗方法组208例,死亡70例;合并OR=0.50,95%的可信区间是(0.32～0.79)。结论从现有的临床证据来看,与常规治疗方法相比,常规治疗方法联合依达拉奉可以延长患者的生存期,降低0.50的死亡危险,但受纳入文献的质量限制,还需要严格设计的、大样本的随机对照试验(randomized controlled trial,RCT)来进一步验证和支持。

OBJECTIVE To evaluate the effectiveness of edaravone for survival of patients with acute cerebral trauma by meta-a- nalysis, in order to give some evidence for dealing acute cerebral trauma. METHODS Studies that strictly followed and compared the effects of conventional treatments in combination with edaravone and conventional treatments on the survival of patients with acute cerebral trauma were searched. The qualities of the studies were evaluated. Then a meta-analysis was carried out on the qualified stud- ies. The odds ratio （OR） for death of the two treatment regiments was calculate. The effectiveness of edaravone for prolonging the sur- vival of patients with acute cerebral trauma was evaluated. RevMan4. 2 software was applied to process data. RESULTS Totally 7 studies including 427 cases were analyzed. There were 219 patients who received conventional treatments in combination with edara- vone, among whom 47 died; while in conventional treatments group there were 208 patients and 70 died. The pooled OR was 0.50 （95% confidence interval 0. 32 -0. 79）. CONCLUSION From the existing clinical evidence, the combination of conventional treat- ments with edaravone can provide some benefit for the survival of patients with acute cerebral trauma. The overall OR for death de- creased by 0. 50 in patients receiving combination treatment compared with that for conventional treatments. However, large-scale ran- domized controlled trials with rigorous design are still needed to verify and support its clinical effectiveness.