抗抑郁药物治疗卒中后抑郁系统评价/Meta分析的方法学再评价研究

Study on Methodology Re-evaluation for Systematic Review/Meta-analysis of Antidepressants in the Treatment of Post-stroke Depression

目的:对已经发表的抗抑郁药物治疗卒中后抑郁的系统评价/Meta分析进行方法学质量再评价。方法:计算机检索Cochrane图书馆、PubMed、Embase、SinoMed、中国知网、万方数据、维普网、中国生物医学文献数据库等数据库,检索时限均为建库起至2019年12月,收集抗抑郁药物治疗卒中后抑郁的系统评价/Meta分析。筛选文献、提取资料后,采用AMSTAR量表评价纳入文献的方法学质量。结果:共纳入33篇系统评价/Meta分析,共523项随机对照试验,涉及41 020例患者。AMSTAR方法学质量评分平均得分为6.76分。西酞普兰、度洛西汀、帕罗西汀等对卒中后抑郁治疗有效,但药物间有效性结论并不一致;帕罗西汀不良反应发生率较低;舍曲林和西酞普兰改善患者神经功能缺损情况尚不明确。结论:抗抑郁药物治疗卒中后抑郁的系统评价/Meta分析方法学质量中等,且各种药物间的有效性、日常生活能力提高、神经功能恢复等结论存在争议。

OBJECTIVE:To re-evaluate the methodology quality of published systematic review/Meta-analysis of antidepressants in the treatment of post-stroke depression.METHODS:Retrieved from Cochrane Library,PubMed,Embase,SinoMed,CNKI,Wanfang database,VIP,CBM and other databases,systematic review/Meta-analysis of antidepressants in the treatment of post-stroke depression were collected during the inception to Dec.2019.After literature screening and data extraction,methodology quality of included literatures were evaluated by using the AMSTAR scale.RESULTS:A total of 33 systematic reviews/Meta-analysis were included,involving 523 RCTs and 41020 patients.Average score of AMSTAR methodological quality evaluation was 6.76.Citalopram,duloxetine and paroxetine were effective for the therapy of post-stroke depression,but the conclusions about the effectiveness among antide-pressants were not consistents.The ADR incidence of Paroxetine was low.It was not clear that sertraline and citalopram may improve the neurological function of patients.CONCLUSIONS:The methodological quality of systematic review/Meta-analysis of antidepressants in the treatment of post-stroke depression is medium,and the conclusions about the effectiveness of antidepressants,improvement of daily life ability and the recovery of neurological function are still controversial.