法舒地尔预防蛛网膜下腔出血后脑血管痉挛的系统性研究

摘要/Abstract

摘要：

目的系统评价法舒地尔对蛛网膜下腔出血患者脑血管痉挛预防疗效价值。方法检索医学文献数据库，筛选法舒地尔对蛛网膜下腔出血患者脑血管痉挛预防疗效对照试验，统计模型为随机效应模型，应用Stata?12.0软件进行Meta分析。结果共7项临床研究符合纳入标准，包含709例患者。与对照组比较，法舒地尔治疗组脑血管痉挛发生率：合并相对危险度（risk ratio，RR）为0.54，95%可信区间为（0.38，0.77），P＜0.05。分别进行以下因素分层分析：改良Jadad评分≥4的研究结果、不同国别（中国与日本）的研究结果、尼莫地平作为对照组，以上分层分析结果表明法舒地尔治疗组脑血管痉挛发生率并未显著低于对照人群。结论对于蛛网膜下腔出血患者，法舒地尔能够降低脑血管痉挛发生率。

文章导读： meta分析显示法舒地尔能预防蛛网膜下腔出血患者脑血管痉挛，但分层分析显示尚缺乏高质量大样本量的对照研究来证实法舒地尔的作用。

关键词: 法舒地尔; 蛛网膜下腔出血; 血管痉挛; 系统评价

Abstract:

Objective To assess the validity of fasudil on preventing vasospasm in patients with subarachnoid hemorrhage. Methods We searched eligible literatures and abstracted data from MEDLINE, EMBASE, Google Scholar and China Biology Medicine disc, and synthesized with Stata?12.0 for meta-analysis by random effect model. Results Seven studies included 709 patients were included in final analysis. When compared with the control group, the incidence of vasospasm in fasudil group was associated with a risk ratio (RR) of 0.54, 95%CI?(0.38, 0.77), P<0.05. Meanwhile, there was no risk difference of vasospasm found in stratified analysis by revised Jadad score above 4, countries (China and Japan), and nimodipine as control group intervention. Conclusion Fasudil in subarachnoid hemorrhage patients may reduce vasospasm incidence. But we failed to demonstrate a significant reduction in stratified analysis.

Key words: Fasudil; Subarachnoid hemorrhage; Vasospasm; Systematic review

李明泉1，舒磊1，刘增军1，刘玲2，王晓霞1，王昕怡1，赵明1. 法舒地尔预防蛛网膜下腔出血后脑血管痉挛的系统性研究[J]. 中国卒中杂志, 2015, 10(01): 45-49.

LI Ming-Quan*, SHU Lei, LIU Zeng-Jun, LIU Ling, WANG Xiao-Xia, WANG Xin-Yi, ZHAO Ming.. Impact of Fasudil on Prevention of Vasospasm in Patients with Subarachnoid Hemorrhage:a Systematic Review and Meta-Analysis[J]. Chinese Journal of Stroke, 2015, 10(01): 45-49.

参考文献

参考文献

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