依达拉奉右莰醇联合阿替普酶治疗急性脑梗死的临床疗效和安全性的系统评价

Systematic Review on Efficacy and Safety of Edaravon Dexborneo Combined with Alteplase in the Treatment of Acute Cerebral Infarction

目的:系统评价依达拉奉右莰醇联合阿替普酶治疗急性脑梗死的临床疗效和安全性,为临床用药选择提供循证学支持。方法:计算机检索PubMed、中国生物医学文献数据库、中国知网、万方数据库、维普数据库等(检索时间为建库至2023年8月),收集依达拉奉右莰醇联合阿替普酶(观察组)对比单用阿替普酶(对照组)治疗急性脑梗死的临床疗效和安全性的随机对照试验(RCT),对符合纳入标准的临床资料进行整理和质量评价,并应用RevMan 5.3软件进行Meta分析。结果:共纳入12项RCT研究,包含1209例患者。Meta分析结果显示,观察组患者的总有效率(RR=1.18,95%CI=1.12~1.23,P<0.00001)、痊愈率(RR=1.55,95%CI=1.21~2.00,P=0.0006)和显效率(RR=1.27,95%CI=1.07~1.51,P=0.006)均高于对照组,美国国立卫生研究院脑卒中量表评分(MD=-2.09,95%CI=-2.84~-1.33,P<0.00001)和无效率(RR=0.28,95%CI=0.18~0.42,P<0.00001)显著低于对照组,以上差异均有统计学意义;两组患者不良反应发生率的差异无统计学意义(RR=1.06,95%CI=0.69~1.61,P=0.80)。结论:依达拉奉右莰醇联合阿替普酶与单用阿替普酶溶栓治疗急性脑梗死相比,临床疗效更优,且安全性相当。

OBJCETIVE:To systematically review the clinical efficacy and safety of edaravon dexborneo combined with alteplase in the treatment of acute cerebral infarction,so as to provide evidence-based support for clinical drug selection.METHODS:PubMed,CBM,CNKI,Wanfang Data and VIP were retrieved to collect the randomized controlled trial(RCT)for clinical efficacy and safety of edaravon dexborneo combined with alteplase(observation group)and alteplase alone(control group)in the treatment of acute cerebral infarction up to Aug.2023.After data extraction and quality evaluation,Meta-analysis was carried out by RevMan 5.3 statistical software.RESULTS:A total of 12 RCT were enrolled,including 1209 patients.Meta-analysis results showed that,the total effective rate(RR=1.18,95%CI=1.12-1.23,P<0.00001),cure rate(RR=1.55,95%CI=1.21-2.00,P=0.0006)and significant effective rate(RR=1.27,95%CI=1.07-1.51,P=0.006)in the observation group were higher than those in the control group,the National Institutes of Health Stroke Scale score(MD=-2.09,95%CI=-2.84--1.33,P<0.00001)and inefficiency rate(RR=0.28,95%CI=0.18-0.42,P<0.00001)were significantly lower than those in the control group,with statistically significant differences.There was no significant difference in the incidence of adverse drug reactions between two groups(RR=1.06,95%CI=0.69-1.61,P=0.80).CONCLUSIONS:Edaravon dexborneo combined with alteplase is clinically more effective and has a comparable safety profile than thrombolysis with alteplase alone in the treatment of acute cerebral infarction.