阿加曲班联合依达拉奉治疗急性脑梗死疗效的Meta分析

Meta-analysis of Effectiveness on Ischemic Cerebral Infarction with Combination Therapy of Argatroban and Edavarone

目的:系统评价阿加曲班联合依达拉奉治疗急性脑梗死的疗效。方法:通过计算机检索PubMed、Cochrane Library、EMBASE、中国知网(CNKI)、中文科技期刊数据库(VIP)、万方数据库(Wanfang Data),搜集从建库至2018-1-31所有阿加曲班联合依达拉奉治疗急性脑梗死患者的文献报道。应用循证医学研究方法,对符合纳入和排除标准的阿加曲班联合依达拉奉治疗急性脑梗死的随机对照试验进行数据提取和质量评价,运用Review Manager 5.3软件进行Meta分析。结果:共有6篇随机对照试验满足纳入标准,共计受试者508人。以总治疗有效率为效应指标进行Meta分析,其合并效应值RR=1.28(95%CI[1.17,1.39],P<0.01)。与单用依达拉奉治疗组相比,阿加曲班联合依达拉奉治疗组治疗前后患者美国国立卫生研究院率中量表(NIHSS)评分变化均数差MD=-3.82(95%CI[-5.21,-2.43]),治疗神经功能缺损程度评分(CSS)评分变化均数差MD=-4.39(95%CI[-6.97,-1.81]),Baroho1量表(BI)改变均数差MD=7.35(95%CI[4.56,10.15]),明显增加,差异均具有统计学意义(P<0.05)。结论:急性脑梗死患者联合应用阿加曲班及依达拉奉使治疗急性脑梗死的总有效率明显高于单用依达拉奉治疗,患者短期神经功能缺损及日常生活活动能力显著改善。

Objective：To systematic analyse the effectiveness acute ischemic cerebral infarction with combination therapy of argatroban and edavarone.Method：We obtained documents about effectiveness on ischemic cerebral infarction with combination therapy of argatroban and edavarone by searching the PubMed,Cochrane library,EMBASE,CNKI,China science and technology Journal database,and Wanfang database（from building a database to 31 January,2018）.Data extraction and quality evaluation were performed after a randomized controlled trial（RCT）that met inclusion and exclusion criteria was found.Meta-analysis was performed by review manager（version 5.3）.Results：A total number of 6 RCT studies were included in our analysis,with a total number of 508 subjects involved.The results of meta-analysis showed that the combination therapy group of argatroban and edavarone was better than the control group in improving patients＇therapeutic efficiency（RR=1.28,95%CI[1.17,1.39],P〈0.01）,NIHSS scores（MD=-3.82,95%CI[-5.21,-2.43],P〈0.01）,CSS scores（MD=-4.39,95%CI[-6.97,-1.81],P〈0.01）,and BI scores（MD=7.35,95%CI[4.56,10.15],P〈0.05）.Conclusion：Current evidence shows that combination therapy of argatroban and edavarone could improve therapeutic efficiency,neurological impairment and activities of daily living abilities in patients with acute ischemic stroke.