艾司西酞普兰预防卒中后抑郁有效性和安全性的Meta分析

Efficacy and safety of escitalopram in preventing post-stroke depression: a meta-analysis

目的系统评价艾司西酞普兰预防卒中后抑郁(post-stroke depression,PSD)的有效性和安全性。方法计算机检索PubMed、The Cochrane Library、CBM、WanFang Data、VIP和CNKI数据库,搜集有关艾司西酞普兰预防PSD有效性和安全性的随机对照试验(RCT),检索时限均从建库至2019年3月。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用RevMan 5.3软件进行Meta分析。结果共纳入6个RCT,包括891例患者。Meta分析结果显示:与对照组相比,使用艾司西酞普兰能降低PSD的发生率[RR=0.55,95%CI(0.31,0.98),P=0.04]。艾司西酞普兰和对照组不良反应发生率的差异无统计学意义(P≥0.05)。结论当前证据显示,艾司西酞普兰能降低PSD的发生,且不增加不良反应发生率。受纳入研究数量和质量的影响,上述结论尚需开展更多高质量研究予以证实。

Objectives To systematically review the efficacy and safety of escitalopram in the prevention of poststroke depression(PSD). Methods PubMed, The Cochrane Library, CBM, WanFang Data, VIP and CNKI databases were electronically searched to collect randomized controlled trials(RCTs) on escitalopram in preventing PSD from inception to March 2019. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed by using RevMan 5.3 software. Results A total of 6 RCTs involving891 patients were included. The results of meta-analysis showed that: compared with the control group, the escitalopram group could reduce the incidence of PSD(RR=0.55, 95%CI 0.31 to 0.98, P=0.04). In addition, there was no statistical difference between escitalopram group and control group in rate of adverse events(P≥0.05). Conclusions Current evidence shows that escitalopram can reduce the incidence of PSD without increasing the incidence of adverse reactions.Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusions.