目的系统评价急性脑梗死rt-PA静脉溶栓后出血性转化的相关危险因素。方法计算机检索PubMed、Web of Science、The Cochrane Library、EMbase、CBM、CNKI、WanFang Data、VIP数据库,搜集与急性脑梗死rt-PA静脉溶栓后出血性转化危险因素...目的系统评价急性脑梗死rt-PA静脉溶栓后出血性转化的相关危险因素。方法计算机检索PubMed、Web of Science、The Cochrane Library、EMbase、CBM、CNKI、WanFang Data、VIP数据库,搜集与急性脑梗死rt-PA静脉溶栓后出血性转化危险因素相关的队列研究或病例-对照研究,检索时限从2010年1月~2020年1月,由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险,采用Rev Man 5.1软件进行meta分析。结果共纳入32个研究,包括1352例患者。meta分析结果显示:大面积脑梗死[OR=4.50,95%CI:1.77~11.47],脑白质疏松[OR=2.91,95%CI:1.68~5.02],溶栓前血糖[OR=3.44,95%CI:2.46~4.81],溶栓后收缩压[OR=2.39,95%CI:1.44~3.96],发病至溶栓时间[OR=2.47,95%CI:1.24~4.91],NIHSS评分[OR=1.11,95%CI:1.08~1.14],房颤[OR=2.80,95%CI:2.13~3.67],是急性脑梗死rt-PA静脉溶栓后出血性转化的危险因素。血尿酸[OR=0.99,95%CI:0.98~1.00]是急性脑梗死rt-PA静脉溶栓后出血性转化的保护因素。结论此次meta分析表明了8项研究因素与急性脑梗死rt-PA静脉溶栓后出血性转化相关,考虑到偏倚存在的可能性,应谨慎解释上述结果,不应让其成为阻止溶栓的理由。展开更多
The main treatments for Parkinson’s disease(PD)currently include surgery,rehabilitation,and most commonly,drug therapy.However,the drugs that are currently used to treat PD provide only symptomatic relief and delayed...The main treatments for Parkinson’s disease(PD)currently include surgery,rehabilitation,and most commonly,drug therapy.However,the drugs that are currently used to treat PD provide only symptomatic relief and delayed disease progression but have no curative effect and cause many adverse reactions.When considering pathogenic factors and metabolic regulation,PD and type 2 diabetes have a high rate of comorbidity;this provides a theoretical basis for the treatment of PD with first-line antidiabetic drugs.Among these agents,metformin reduces neuronal damage in the brains of PD patients via neuroprotection and the inhibition of oxidative stress and inflammatory responses,thus providing a novel strategy for the clinical treatment of PD.Here,we present the current state of knowledge about the use of metformin to treat PD and discuss its clinical prospects.展开更多
文摘目的系统评价急性脑梗死rt-PA静脉溶栓后出血性转化的相关危险因素。方法计算机检索PubMed、Web of Science、The Cochrane Library、EMbase、CBM、CNKI、WanFang Data、VIP数据库,搜集与急性脑梗死rt-PA静脉溶栓后出血性转化危险因素相关的队列研究或病例-对照研究,检索时限从2010年1月~2020年1月,由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险,采用Rev Man 5.1软件进行meta分析。结果共纳入32个研究,包括1352例患者。meta分析结果显示:大面积脑梗死[OR=4.50,95%CI:1.77~11.47],脑白质疏松[OR=2.91,95%CI:1.68~5.02],溶栓前血糖[OR=3.44,95%CI:2.46~4.81],溶栓后收缩压[OR=2.39,95%CI:1.44~3.96],发病至溶栓时间[OR=2.47,95%CI:1.24~4.91],NIHSS评分[OR=1.11,95%CI:1.08~1.14],房颤[OR=2.80,95%CI:2.13~3.67],是急性脑梗死rt-PA静脉溶栓后出血性转化的危险因素。血尿酸[OR=0.99,95%CI:0.98~1.00]是急性脑梗死rt-PA静脉溶栓后出血性转化的保护因素。结论此次meta分析表明了8项研究因素与急性脑梗死rt-PA静脉溶栓后出血性转化相关,考虑到偏倚存在的可能性,应谨慎解释上述结果,不应让其成为阻止溶栓的理由。
基金This work was supported by the Natural Science Basic Research Plan in Shaanxi Province of China(No.2019JM-098,to JM)the National Natural Science Foundation of China(No.31371298,81301151,to JM)+1 种基金Opening Project of the Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research,College of Stomatology,Xi’an Jiaotong University,China(No.2017LHM-KFKT007,to JM)the National Innovation Experiment Program for University Students(No.GJ201810698126,to JM).
文摘The main treatments for Parkinson’s disease(PD)currently include surgery,rehabilitation,and most commonly,drug therapy.However,the drugs that are currently used to treat PD provide only symptomatic relief and delayed disease progression but have no curative effect and cause many adverse reactions.When considering pathogenic factors and metabolic regulation,PD and type 2 diabetes have a high rate of comorbidity;this provides a theoretical basis for the treatment of PD with first-line antidiabetic drugs.Among these agents,metformin reduces neuronal damage in the brains of PD patients via neuroprotection and the inhibition of oxidative stress and inflammatory responses,thus providing a novel strategy for the clinical treatment of PD.Here,we present the current state of knowledge about the use of metformin to treat PD and discuss its clinical prospects.
