硫酸镁治疗动脉瘤性蛛网膜下腔出血的Meta分析

Magnesium sulphate for aneurysmal subarachnoid hemorrhage:A Meta-analysis of randomized placebo-controlled trials

目的:探讨硫酸镁在动脉瘤性蛛网膜下腔出血中的治疗效果和应用前景,并为进一步研究提供循证医学依据。方法:根据设定的纳入、排除标准,在Pubmed、Cochrane数据库、中国生物医学文献数据库(CBM)、万方数据库、CNKI知识网络服务平台及其他期刊进行相关随机对照试验检索。单变量计数资料的效应量用优势比(OR)和95%可信区间(95%CI)表示,用Revman5.2软件对数据进行异质性检验后采用固定效应模型或随机效应模型对数据进行分析。结果:经过检索和初步筛选,共检索出1980年-2016年间发表的148篇相关文献,通过筛选最终得到8篇包含2 143例动脉瘤性蛛网膜下腔出血患者的随机对照试验符合所纳入的标准。结果显示硫酸镁能够显著提高患者预后,OR:1.33(95%置信区间:1.10~1.59),并且显著降低临床脑血管痉挛的风险,OR:0.47(95%置信区间:0.32~0.68)。结论:动脉瘤性蛛网膜下腔出血早期应用硫酸镁能够有效改善预后并降低脑血管痉挛的发生风险。

Objective：To study the efficacy and prospects of magnesium sulphate in the treatment of aneurysmal subarachnoid hemorrhage and to provid the evidence based medicine foundation to further researches.Methods：We searched all the published randomized placebo-controlled trials in Pubmed,Cohrane Controlled Trials Register,China Biology Medicine disc,Wan-fang data base,CNKI and other periodicals according to the included or excluded standards.The effects size（ES）univariate enumeration data were expressed as odds ratio（OR）and 95% confidence interval（95%CI）.Undergoing the heterogeneity test,we analyzed the data with fixed effect model or random effect model by Revman5.2.Results：We have totally found 148 papers published from 1980 to 2016.Finally we chose 8 randomized placebo-controlled trials matched the standards in which enrolled 2 143 aneurysmal subarachnoid hemorrhage patients.The results showed that magnesium sulphate can significantly improve the outcomes of these patients,OR：1.33（95%CI：1.10~1.59）,and reduce the risk of cerebral vasospasm,OR：0.47（95%CI：0.32~0.68）.Conclusion：An early application of magnesium sulphate for aneurysmal subarachnoid hemorrhage could significantly improve the outcomes of the patents and reduce the risk of cerebral vasospasm.