症状性颅内动脉粥样硬化性狭窄支架辅助治疗疗效评价:基于中国人群的Meta分析

Effect of stent-assisted treatment on symptomatic intracranial atherosclerotic stenosis: A Meta-Analysis based on Chinese population

目的系统性评价支架辅助治疗及单纯药物治疗对基于中国人群的症状性颅内动脉粥样硬化性狭窄(ICAS)疗效的影响。方法计算机检索中国生物医学文献数据库、中国期刊全文数据库、Pubmed和Cochrane Library数据库。收集有关ICAS单纯药物治疗与支架辅助治疗不良事件比较的随机对照试验(RCT)。由两位研究者按照纳入与排除标准独立筛选文献、提取资料和评价质量后,采用Stata12.0软件进行Meta分析。结果 11篇文献纳入Meta分析,Meta分析结果显示,30 d不良事件随访结果提示单纯药物治疗组与支架辅助治疗组的比较差异无统计学意义[OR=1.44,95%CI(0.86,2.41),Z=1.37,P>0.05];而支架辅助治疗组的1年期不良事件随访结果 [OR=0.62,95%CI(0.40,0.95),Z=2.21,P<0.05]与3年期不良事件随访结果 [OR=0.65,95%CI(0.46,0.92),Z=2.42,P<0.05]显著优于单纯药物治疗组。结论支架辅助治疗的中远期疗效优于单纯药物治疗。

Objective To compare the efficacy of stent-assisted treatment and standard medical treatment on symptomatic intracranial atherosclerotic stenosis（ICAS） in Chinese population. Methods The randomized controlled trials（RCTs） on ICAS treated by stent-assisted treatment were identified from Chinese biomedical literature database, China periodical full text database, Pubmed and Cochrane Library database. According to the inclusion and exclusion criteria,two reviewers independently screened the studies,extracted data, and evaluated the methodological quality. Then, meta-analysis was conducted using Stata12.0 software. Results Eleven RCTs were included in the analysis of meta, trials. The results of meta-analyses indicated that the 30 d adverse events between the stent-assisted treatment and standard medical treatment showed no significant differences [OR = 1.44, 95%CI（0.86, 2.41）, Z = 1.37, P 0.05], and the 1-year adverse events [OR = 0.62, 95% CI（0.40, 0.95）, Z = 2.21, P 0.05] and 3-year adverse events [OR = 0.65, 95%CI（0.46, 0.92）, Z = 2.42, P 0.05] treated by stent-assisted therapy were much better than those in the standard medical treatment. Conclusion The long-term clinical efficacy of stent-assisted treatment is better than standard medical treatment.