米诺环素治疗急性脑卒中效果的meta分析

Meta-analysis of effects of minocycline on acute stroke

目的:评价米诺环素治疗急性脑卒中的疗效。方法:严格按照纳入、排除标准,搜索中国知网、万方、PubMed、Web of Science、Cochrane Library和Embase数据库,检索词为“米诺环素”“脑卒中”“脑缺血”“脑出血”“minocycline”“stroke”“intracerebral hemorrhage”“ischemic stroke”等,并进行meta分析,以研究米诺环素对急性脑卒中的疗效。结果:分别纳入8篇临床研究以及10篇动物实验。临床研究meta分析结果显示:米诺环素组NIHSS评分(WMD=-2.38,95%CI=-4.46^-0.31)、mRS评分(WMD=-0.92,95%CI=-1.51^-0.34)、BI评分(WMD=9.07,95%CI=1.15~16.99)均优于对照组(P<0.05)。动物实验meta分析结果显示:米诺环素组脑梗死体积(SMD=-2.15,95%CI=-2.71^-1.60)、病灶体积(SMD=-2.70,95%CI=-3.65^-1.75)、脑水肿体积(SMD=-2.78,95%CI=-3.66^-1.90)均小于对照组(P<0.05)。结论:米诺环素在急性脑卒中患者尤其是缺血亚群中显示出了良好的神经保护作用。

Aim:To evaluate the effects of minocycline on acute stroke.Method:In strict accordance with inclusion and exclusion criteria,CNKI,Wanfang,PubMed,Web of Science,Cochrane Library and Embase databases were searched.The key words were"minocycline""stroke""intracerebral hemorrhage""ischemic stroke".Meta-analysis was performed to evaluate the effects of minocycline on acute stroke.Result:A total of 8 clinical studies and 10 animal experiments were included.In the clinical studies of cerebral stroke,the results of meta-analysis showed that NIHSS score(WMD=-2.38,95%CI=-4.46--0.31),mRS score(WMD=-0.92,95%CI=-1.51--0.34),BI score(WMD=9.07,95%CI=1.15-16.99)in the minocyclin group were significantly better compared with those of the control group(P<0.05).In the animal experiments for stroke,the results of meta-analysis showed that the volume of cerebral infarction(SMD=-2.15,95%CI=-2.71--1.60),lesion volume(SMD=-2.70,95%CI=-3.65--1.75),cerebral edema volume(SMD=-2.78,95%CI=-3.66--1.90)in the minocyclin group were lower compared with those of the control group(P<0.05).Conclusion:Minocycline shows good neuroprotective effects in acute stroke,especially in ischemic subgroup.