肌氨肽苷治疗缺血性脑卒中临床疗效的Meta分析

Clinical efficacy of muscular amino acids and nucleosides in the treatment of ischemic stroke:a Meta-analysis

目的 对肌氨肽苷治疗缺血性脑卒中的临床疗效进行Meta分析,以期为临床实践提供参考。方法 计算机检索Pubmed、Embase、Cochrane Library、中国知网、万方数据库、中国生物医学文献服务系统,检索时限从建库截止到2021年5月10日。按纳入与排除标准筛选文献、提取资料并评估纳入研究的研究质量,采用Revman Manager 5.3软件进行Meta分析。结果 共纳入4篇研究,包括3篇随机对照试验(RCT)研究、1篇观察性研究,涉及464例患者。Meta分析结果显示:肌氨肽苷治疗缺血性脑卒中的临床总有效率优于胞二磷胆碱,差异具有统计学意义[风险比(RR)=1.15,95%置信区间(CI)=(1.04,1.28),P=0.008<0.05]。肌氨肽苷治疗缺血性脑卒中的治愈率优于胞二磷胆碱,差异具有统计学意义[RR=1.58,95%CI=(1.13,2.21),P=0.007<0.05]。肌氨肽苷治疗缺血性脑卒中的有效率与胞二磷胆碱比较差异无统计学意义[RR=1.13,95%CI=(0.77,1.65),P=0.53>0.05]。结论 基于现有临床证据,与胞二磷胆碱相比,肌氨肽苷治疗缺血性脑卒中的临床疗效可能具有非劣效性。由于纳入研究的数量太少且质量不高,该结论有待更多高质量的RCT研究进一步验证。

Objective Meta-analysis of the clinical efficacy of muscular amino acids and nucleosides in the treatment of ischemic stroke,in order to provide reference for clinical practice.Methods Pubmed,Embase,the Cochrane Library,CNKI,Wanfang Database and China Biomedical Literature Service System were electronically searched up to May 10,2021.The literature was screened by inclusion and exclusion criteria,extracted and assessed for study quality of included studies,and Meta-analysis was performed using Revman Manager 5.3 software.Results A total of 4 studies were included,including 3 randomized controlled trials(RCT)studies and 1 observational study involving 464 patients.Meta-analysis showed that the overall clinical efficiency of muscular amino acids and nucleosides for ischemic stroke was better than that of citicoline,with a statistically significant difference[risk ratio(RR)=1.15,95%confidence interval(CI)=(1.04,1.28),P=0.008<0.05].The cure rate of muscular amino acids and nucleosides in the treatment of ischemic stroke was better than that of citicoline,and the difference was statistically significant[RR=1.58,95%CI=(1.13,2.21),P=0.007<0.05].There was no statistically significant difference in the effective rate of muscular amino acids and nucleosides in the treatment of ischemic stroke compared with citicoline[RR=1.13,95%CI=(0.77,1.65),P=0.53>0.05].Conclusion Based on the existing clinical evidence,muscular amino acids and nucleosides may have non-inferior efficacy for treatment ischemic stroke compared with citicoline.The conclusion needs to be further verified by more high-quality RCTs.