替罗非班应用于进展性缺血性脑卒中有效性及安全性的meta分析

Meta-analysis of the efficacy and safety of Tirofiban in the treatment of progressive ischemic stroke

目的评价替罗非班治疗进展性缺血性脑卒中(PIS)的有效性及安全性。方法通过检索从建库至2022年5月1日的万方、维普、知网、中国生物医学文献数据库(CBM)、临床注册中心及PubMed、Cochrane Library、Web of Science、Embase数据库,纳入符合标准的随机对照试验(RCTs)。用RevMan 5.3进行质量评价,用STATA.16进行meta分析。结果最终纳入33项研究,共2757例患者,试验组1365例,对照组1392例。Meta分析结果显示:替罗非班用于PIS患者,试验组有效性显著高于对照组,有效率方面,合并效应量[RR=1.24,95%CI(1.18~1.30),P<0.00001];预后方面,合并效应量[RR=1.64,95%CI(1.36~1.98),P<0.00001];90 d NIHSS评分情况,合并效应量[SMD=-0.73,95%CI(-0.89~-0.58),P<0.0001]。替罗非班用于PIS患者其任何部位发生出血的风险与对照组无显著差异,合并效应量[RR=1.20,95%CI(0.92~1.57),P=0.186]。结论替罗非班用于PIS,疗效优于对照组,可以显著改善患者预后,提高生活质量,且不增加出血风险。

Objective To evaluate the efficacy and safety of Tirofiban in the treatment of progressive ischemic stroke(PIS).Methods By searching Wanfang,VIP,CNKI,China Biology Medicine disc(CBM),Chinese Clinical Trial Registry(ChiCTR),PubMed,Cochrane Library,Web of Science and Embase databases from the establishment of the databases to May 1,2022,selected according to the indusion and exclusion criteria of the randomized controlled trials(RCTs).RevMan 5.3 was used for quality evaluation and STATA.16 was used for meta-analysis.Results Finally,a total of 33 studies were admitted and 2757 patients were included.And they were divided into the experimental group(n=1365)and the control group(n=1392).Meta-analysis results showed that when Tirofiban was used in patients with PIS,the effectiveness of the experimental group was significantly higher than the control group.In terms of effective rate,the combined effect size was(RR=1.24,95%CI[1.18-1.30],P<0.00001);In terms of prognosis,the combined effect size was(RR=1.64,95%CI[1.36-1.98],P<0.00001);In terms of 90-day NIHSS score,the combined effect size was(SMD=-0.73,95%CI[-0.89--0.58],P<0.0001).There was no statistically significant difference in the risk of hemorrhage in any part of PIS patients with Tirofiban compared with the control group,and the combined effect size was(RR=1.20,95%CI[0.92-1.57],P=0.186).Conclusion Tirofiban used for the treatment of PIS has superior therapeutic efficacy than the control group.It can significantly improve the prognosis and quality of life of patients without increasing the risk of hemorrhage.