丁苯酞氯化钠注射液联合阿替普酶治疗急性脑梗死安全性、有效性的系统评价

Safety and Efficacy of Alteplase Combined with Butylphthalide Injection in the Treatment of Acute Cerebral Infarction:A Systematic Review

目的:系统评价丁苯酞氯化钠注射液联合阿替普酶治疗急性脑梗死的疗效和安全性。方法:检索中国知网、维普、万方、CBM、Medline、Embase、Cochrane Library、Pubmed数据库,纳入所有符合标准的随机对照试验,对纳入文献进行质量评价,采用Review Manager 5.3.5软件进行Meta分析。结果:共纳入17个研究,1842例患者,924例患者接受丁苯酞氯化钠注射液联合阿替普酶,918例接受阿替普酶治疗。试验组总有效率(OR=3.95,95%CI[2.89,5.38],P<0.00001)、Barthel指数生活能力评价(BI)(MD=9.01,95%CI[4.33,13.70],P<0.00001)、日常生活能力评分(ADL)均显著高于对照组(MD=9.00,95%CI[4.90,13.09],P<0.0001),试验组神经功能缺损评分(NIHSS)下降水平(MD=-2.00,95%CI[-2.62,-1.38],P<0.00001)、血清超敏C反应蛋白(hs-CRP)水平明显低于对照组(MD=-3.37,95%CI[-5.63,-1.11],P<0.00001)。结论:丁苯酞氯化钠注射液联合阿替普酶治疗急性脑梗死疗效显著优于阿替普酶,且安全性较好。

Objective:To assess the safety and efficacy of Alteplase combined with butylphthalide injection for acute cerebral infarction(ACI).Methods:search CNKI,WeiPu Data,Wang Fang,CBM,Medline,Embase,Cochrane Library,Pubmed for randomized controlled trials(RCTs)of related articles.Results:There were 17 studies were included with a total of 1842 patients,942 received Alteplase combined with butylphthalide injection,and 918 received Alteplase.The overall effective rate(OR=3.95,95%CI[2.89,5.38],P<0.00001)、BI score(MD=9.01,95%CI[4.33,13.70],P<0.00001)and ADL score(MD=9.00,95%CI[4.90,13.09],P<0.0001)of the experimental group were significantly better than that of the control group;the NIHSS score of the test group(MD=-2.00,95%CI[-2.62,-1.38],P<0.00001)and hs-CRP Level(MD=-3.37,95%CI[-5.63,-1.11],P<0.00001)of the experimental group were significantly better than the control group.Conclusion:Butylphthalide injection combined with alteplase is more effective and safer than alteplasealone in the treatment of ACI.