促红细胞生成素治疗急性颅脑损伤疗效的meta分析

Effect of erythropoietin on acute traumatic brain injury and its safety: a meta-analysis

目的系统评价促红细胞生成素(EPO)治疗急性颅脑损伤的有效性和安全性。方法计算机检索The Cochrane Li brary、Clinical Trials、Web of Science、PubMed、EMbase、中国生物医学文献数据库、中国知网数据库和万方数据库,检索年限均从建库至2018年5月。搜集EPO治疗急性颅脑损伤的临床随机对照试验,试验组采用EPO治疗,对照组采用安慰剂或空白对照。采用RevMan 5.3软件进行meta分析。结果纳入7项临床随机对照研究,共计1101例,试验组564例,对照组537例。meta分析显示:EPO显著降低病死率(RR=0.69;95%CI 0.51~0.94;P=0.02),不能改善神经功能(RR=1.28;95%CI 0.90~1.81;P=0.17),不增加深静脉血栓形成发生率(RR=1.00;95%CI=0.74~1.35;P=0.99)。结论EPO治疗急性颅脑损伤可以降低死亡率,无明显严重的不良反应,但不能改善神经功能。

Objective To evaluate the effect of erythropoietin on acute traumatic brain injury(TBI)and its safety.Methods The databases including Cochrane Library,Clinical Trials,EMbase were searched for randomized controlled trial(RCTs)about the treatment of acute TBI with erythropoietin.The RevMan 5.3 software was used for the meta-analysis of the obtained data.Results Seven RCTs which were obtained included 1100 patients.The Meta analysis showed that the mortality was significantly lower in the patients with acute TBI treated by erythropoietin than that in the patients of the control group(P<0.05),but there were insignificant differences in the neurologic function and the rate of the deep vein thrombosis occurrence between the treatment group and control group(P<0.05).Conclusions Erythropoietin can reduce the mortality rate,but it is insignificantly helpful to improvement of neurologic function and it can not enhance the risk of deep vein thrombosis in the patients with acute TBI.