红花黄色素对急性脑梗死患者血液流变学影响的Meta分析

Effects of safflow yellow on hemorheology of patients with acute cerebral infarction: a Meta-analysis with trial sequential analysis

目的系统评价红花黄色素对急性脑梗死患者血液流变学的改善作用。方法通过全面检索与红花黄色素治疗急性脑梗死相关的临床随机对照试验研究,运用Cochrane图书馆的系统评价方法,对所纳入的文献进行质量评价,采用Ravman 5.3软件进行Meta分析,采用TSA 0.9软件进行序贯分析。结果 19项随机对照试验被纳入系统评价,涉及患者780例。2Meta分析结果表明,红花黄色素有助于降低急性脑梗死患者的血浆黏度[OR=-0.17,95%CI(-0.27,-0.06),P<0.00001],改善红细胞压积水平[OR=-2.27,95%CI(-3.36,-1.18),P<0.00001],敏感性分析及TSA序贯分析均证实结果可信。3红花黄色素在降低急性脑梗死患者纤维蛋白原水平方面,并未显示出特殊优势[OR=-0.60,95%CI(-1.52,0.33),P<0.00001],仍需进一步验证。结论现有证据显示,红花黄色素可以明显改善急性脑梗死患者的血浆黏度,降低红细胞压积,纠正血液高黏状态。

Objective To systematically assess the effects of safflow yellow on hemorheology of patients with acute cerebral infarction. Methods A comprehensive search was preformed on relevant randomized controlled trials （RCTs） which investigated the effects of safflow yellow on hemorheology of patients with acute cerebral infarction. Systematic evaluational methods offered by Cochrane Library were used to evaluate those included literature. Then Meta-analysis and trial sequential analysis were performed by software RevMan 5.3 and TSA 0.9 respectively. Results ①Tota]ly 9 RCTs which involved 780 participants were included in system evaluation. ②The Meta-analysis results well suggested that sail＇low yellow effectively reduced the plasma viscosity（PV）[ OR = -0.17,95% CI（ -0.27, -0.06 ） , P 〈0. 00001 ] ,and improved the hematokrit（HCT） [ OR = -2.27,95% CI（ -3.36, -1.18 ） ,P 〈0. 00001 ]. Sensitivity analysis arid TSA sequential analysis confirmed the credibility of the results. ③There was no obvious difference on fibrinogen degree between groups [ OR = -0. 60,95% CI（ -1.52,0.33 ）, P 〈 0. 00001 ] ,which needed further validation. Conclusion Safffow yellow could improve the plasma viscosity and hematnkrit of patients with acute cerebral infarction, which corrected the blood viscous state.