Abstract: Objective To assess the efficacy of Urinary Kallid for patients with acute cerebral infarction.Methods We searched CBMdisc (1978～2010), CNKI (1979～2010), VIP (1989～2010), Wanfang Database (1978～2010) by electronic database and relevant journals such as Chinese Journal ofNeurology, Journal of Clinical Neurology, Journal of Apoplexy and Nervous Diseases and ChineseJournal of Clinical Neurosciences etc. by manual searching to collect all randomized controlledtrials (RCTs) and quasi-randomized controlled trials (quasi-RCTs) of Urinary Kallid for patientswith acute cerebral infarction. The quality of included studies was assessed according to the criteriarecommended by the Cochrane Handbook for Systematic Reviews of Interventions and data wereextracted by two reviewers independently. Meta-analysis was conducted by RevMan 5.0 software.Results Fifty-seven studies involving 5273 patients were included. The results of meta-analysisshowed that: 1. The incidence of aggravated rate in the Urinary Kallid group was lower than that inthe control group (RR =0.38, 95%CI 0.27 to 0.52, P <0.01); 2. There were no differences betweenthe two groups in the incidence of mortality (RR =0.47, 95%CI 0.13 to 1.73, P =0.26); 3. There weresignificant differences between the two groups in the influence of Barthel Index (BI) (WMD=7.97,95%CI 3.34 to 12.6, P =0.0007); 4. There were significant differences between the two groups in theinfluence of The National Institutes of Health Stroke Scale (NIHSS) (WMD=-2.37, 95%CI -2.95 to-1.79, P <0.01); 5. The incidence of adverse reaction in the Urinary Kallid group was higher than thatin the control group, but the degree was slight, symptomatic treatment could make the syndromesrelieving.Conclusion Urinary Kallid shows an effective reduction in the incidence of aggravated rate, itcan improve BI and NIHSS. There are no differences between the two groups in the incidence ofmortality, and the incidence of adverse reaction in the Urinary Kallid group is higher than that inthe control group, but has no influence in treatment.

Key words: Brain infarction; Urinary Kallid; Randomized controlled trial; Meta-analysis

摘要： 目的 系统评价尤瑞克林（Urinary Kallid）治疗急性脑梗死的疗效及安全性。方法 计算机检索中国生物医学文献数据库（China Biology Medicine disc，CBMdisc，1978～2010年）、中国学术期刊全文数据库（China Academic Journal，CAJ，1979～2010年）、中文科技期刊全文数据库（VIP，1989～2010年）、万方数据库（1978～2010年）等，手工检索中华神经科杂志、临床神经病学杂志、中风与神经疾病杂志、中国临床神经科学等相关杂志，收集国内关于尤瑞克林治疗急性脑梗死的随机或半随机对照试验。按Cochrane系统评价的方法，由两名研究者独立进行质量评价和资料提取，采用RevMan 5.0软件进行Meta分析。结果 共纳入57篇已发表文献，包括5273例急性脑梗死患者。Meta分析结果显示：①尤瑞克林组病情恶化率低于对照组[相对危险度（relative risk，RR）=0.38，95%可信区间（confidence interval，CI ）为0.27～0.52，P <0.01]；②尤瑞克林组死亡率与对照组差异无统计学意义[RR =0.47，95%CI为（0.13～1.73），P =0.26]；③采用Bathel指数（Barthel Index，BI）量表评定日常生活活动能力，尤瑞克林组与对照组评分差异有统计学意义[加权均数差（weighted mean difference，WMD）=7.97，95%CI（3.34～12.6），P =0.0007]；④采用美国国立卫生研究院卒中量表（The National Institutes ofHealth Stroke Scale，NIHSS）评价神经功能缺损情况，尤瑞克林组与对照组评分差异有统计学意义[WMD =-2.37，95%CI（-2.95～-1.79），P <0.01]。⑤尤瑞克林组不良反应发生率较对照组高，但程度轻微，不影响治疗。结论 尤瑞克林可降低急性脑梗死患者病情恶化率，改善患者第14天BI及NIHSS评分情况；尤瑞克林对死亡率的影响与对照组差异无统计学意义；其不良反应发生率较对照组高，但不影响治疗。

关键词: 脑梗死; 尤瑞克林; 随机对照试验; Meta分析