普罗布考联合阿托伐他汀治疗急性脑梗死的系统评价与Meta分析

Systematic Evaluation and Meta-analysis of Probucol Combined with Atorvastatin in the Treatment of Acute Cerebral Infarction

目的:系统评价普罗布考联合阿托伐他汀治疗急性脑梗死(acute cerebral infarction,ACI)的效果和安全性。方法:使用计算机检索2010年1月1日—2020年12月31日已发表的有关普罗布考联合阿托伐他汀治疗ACI患者的随机对照试验相关文献,剔除不符合纳入标准的文献,参照改良Jadad评分标准,评估文献质量;采用RevMan5.0软件进行Meta分析。结果:最终纳入符合条件的随机对照试验共10个,研究对象共1147例。全部纳入的10篇文献中,6篇文献观察分析了治疗后颈动脉内中膜厚度(intima-media thickness,IMT),均可提取有效数据;7篇文献观察分析了治疗后低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C),均可提取有效数据;5篇文献观察了治疗后美国国立卫生研究院卒中量表(national institutes of health stroke scale,NIHSS)评分,均可提取有效数据。将全部主要结局指标数据录入后,经Meta分析结果显示,较单用阿托伐他汀治疗,普罗布考联合阿托伐他汀治疗ACI后,IMT更低[MD=-0.27,95%CI(-0.29,-0.25),P<0.001]、LDL-C更低[MD=-0.32,95%CI(-0.36,-0.27),P<0.001]、NIHSS更低[MD=-1.18,95%CI(-1.37,-1.00),P<0.001]。纳入文献中不良反应结果无法合并分析,安全性优势有待进一步评估。结论:普罗布考联合阿托伐他汀治疗ACI,在改善动脉粥样硬化、调节血脂、减轻神经功能缺损方面更具优势,但安全性仍需进一步评估。

Objective:To systematically evaluate the efficacy and safety of Probucol combined with Atorvastatin in the treatment of acute cerebral infarction(ACI).Method:Literatures on randomized controlled trials of Probucol combined with Atorvastatin in the treatment of patients with ACI published from January 1st,2010 to December 31st,2020 were searched by computer.Literatures that did not meet the inclusion criteria were excluded,and the quality of the literatures was evaluated according to the modified Jadad scoring standard.Meta-analysis was performed using RevMan5.0 software.Result:Finally,a total of 10 eligible randomized follow-up trials were included,with a total of 1,147 subjects.In all 10 literatures included,6 literatures of them observed and analyzed carotid artery intima-media thickness(IMT)after treatment,and effective data could be extracted from all of them;7 literatures of them observed and analyzed low density lipoprotein cholesterol(LDL-C)after treatment,and effective data could be extracted from all of them;5 literatures of them observed and analyzed national institute of health stroke scale(NIHSS)score after treatment,and effective data could be extracted from all of them.After data entry of all major outcome indicators,Meta-analysis results showed that:compared with Atorvastatin therapy alone,Probucol combined with Atorvastatin in ACI treatment had lower IMT[MD=-0.27,95%CI(-0.29,-0.25),P<0.001]and lower LDL-C[MD=-0.32,95%CI(-0.36,-0.27),P<0.001]and lower NIHSS[MD=-1.18,95%CI(-1.37,-1.00),P<0.001].The results of adverse reactions in the included literature could not be pooled,and the safety advantage needs to be further evaluated.Conclusion:Probucol combined with Atorvastatin in the treatment of ACI has more advantages in improving atherosclerosis,regulating blood lipids and alleviating neurological deficits,but the safety needs to be further evaluated.