关键词: 缺血性卒中; 指南; 药物治疗; 系统评价; 临床指南研究与评估系统Ⅱ

Abstract:

Objective To evaluate the evidence and recommendations of the Chinese guidelines on pharmacotherapy for ischemic stroke in the recent five years. Methods The domestic computer retrieval platforms (China biomedical literature database, CNKI, WanFang Data, etc) and foreign platforms (Pubmed, NGC, GIN, etc) were retrieved. The retrieval time limit ranged from January 2012 to May 2017. Appraisal of Guidelines for Research and Evaluation II (AGREE II) was used to assess the quality of the guidelines. Results A total of 19 guidelines were finally included. The average scoring rates of the 19 guidelines in the 6 field of AGREE II, including the scope and purpose, participants, rigor of the formulation, clarity of expression, applicability, and independence of the editors were 60%, 19%, 26%, 55%, 23%, and 2%, respectively. At present, the effective time window of intravenous thrombolytic drugs was still in the super early period (<4.5 h), and the benefit of the increase of thrombolytic indications was still unclear. For mild stroke, the dual antiplatelet therapy was recommended by all different guidelines. The timing of anticoagulation was still the most controversial part among all guidelines. The control of blood pressure of ischemic stroke should follow the principle of individuation firstly.The efficacy of neuroprotectant was still in need of a lot of clinical trials. Conclusion The guidelines in this field can reflect the difficult and hot issues in clinical practice and provide better guidance for the clinical practice of pharmacotherapy for stroke. However, the methodological quality about the Chinese guidelines on pharmacotherapy for ischemic stroke was low or moderate in general. The methodological quality of guidelines should be further improved.

Key words: Ischemic stroke; Guideline; Pharmacotherapy; Systematic review; Appraisal of Guidelines for Research and Evaluation II