强化胰岛素疗法在脑卒中治疗中的作用:Meta分析

Intensive versus conventional insulin therapy in stroke(a Meta-analysis)

目的评价强化胰岛素疗法在脑卒中救治中的作用。方法系统检索中、外文文献数据库临床随机对照试验后行meta分析。评价病死率、远期神经功能评分、低血糖事件发生率等。结果共纳入文献11篇。病死率合并OR=0.85(95%CI0.53,1.36;P=0.50);远期神经功能评分合并OR=1.00(95%CI0.78,1.29;P=0.99);低血糖事件发生率合并OR=7.81(95%CI5.17,11.80;P<0.00001)。结论脑卒中救治中,强化胰岛素疗法在病死率和远期神经功能方面,与常规胰岛素疗法无明显差别,但低血糖事件发生率却明显增多。

Objective To evaluate the effects of intensive insulin therapy （IIT） and conventional insulin therapy （CIT） in stroke patients management. Methods .,We systematically searched databases of Chinese and non-Chinese literatures for randomized controlled trial （RCT）. The outcome parameters included mortality,late neurological severity scale（NSS） and hypoglycemia episodes. Results Eleven studies were retrieved eventually. The pooled OR of mortality is 0.85 （95% CI0.53, 1.36;P=0.50）. The pooled ORofNSSis 1.00 （95% CI0.78, 1.29; P= 0.99）. The pooled OR of hypoglycemia episodes is 7.81 （95% CI 5.17, 11.80,P 〈 0.00 001 ） with significance statistically. Conclusions In the management of stroke, there were no significant changes between IIT and CIT. However, IIT resulted a much higher hypoglycemia prevalence.