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低分子肝素联合依达拉奉治疗进展性脑梗死疗效的系统评价

黎敏, 唐震宇, 沈小平

黎敏, 唐震宇, 沈小平. 低分子肝素联合依达拉奉治疗进展性脑梗死疗效的系统评价[J]. 循证医学, 2013, 13(4): 218-224. DOI: 10.3969/j.issn.1671-5144.2013.04.010
引用本文: 黎敏, 唐震宇, 沈小平. 低分子肝素联合依达拉奉治疗进展性脑梗死疗效的系统评价[J]. 循证医学, 2013, 13(4): 218-224. DOI: 10.3969/j.issn.1671-5144.2013.04.010
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LI Min, TANG Zhen-yu, SHEN Xiao-ping. Efficacy and Safety of Low Molecular Weight Heparin Combined with Edaravone in the Treatment of Progressive Cerebral Infarction: A Systematic Review[J]. Journal of Evidence-Based Medicine, 2013, 13(4): 218-224. DOI: 10.3969/j.issn.1671-5144.2013.04.010
Citation: LI Min, TANG Zhen-yu, SHEN Xiao-ping. Efficacy and Safety of Low Molecular Weight Heparin Combined with Edaravone in the Treatment of Progressive Cerebral Infarction: A Systematic Review[J]. Journal of Evidence-Based Medicine, 2013, 13(4): 218-224. DOI: 10.3969/j.issn.1671-5144.2013.04.010
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低分子肝素联合依达拉奉治疗进展性脑梗死疗效的系统评价

  • 南昌大学第二附属医院神经内科, 南昌 330006

详细信息
    作者简介:

    作者简介] 黎敏（1988-）,男,江西萍乡人,硕士研究生,从事神经病学研究。

    通讯作者:

    唐震宇,Tel: 0791-86311759, E-mail: tangzyjr@sina.com

  • 中图分类号: R743

Efficacy and Safety of Low Molecular Weight Heparin Combined with Edaravone in the Treatment of Progressive Cerebral Infarction: A Systematic Review

  • Department of Neurology Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang 330006, China

摘要

    摘要
  • 摘要: 目的 评价低分子肝素联合依达拉奉注射液治疗进展性脑梗死的有效性和安全性。 方法 计算机检索中国期刊全文数据库、中国生物医学文献数据库、中文科技期刊数据库、万方数字化期刊全文库、PubMed、MEDLINE、EMBASE数据库,截止至2012年4月,并追踪已获文献的参考文献。筛选所有使用低分子肝素联合依达拉奉注射液治疗进展性脑梗死的随机对照试验,对照组为使用低分子肝素加常规内科治疗的进展性脑梗死患者。严格按照纳入和排除标准选择文献、提取数据、评价质量。采用RevMan 5.0.0软件进行Meta分析。 结果 共纳入11个随机对照试验,合计867例进展性脑梗死患者,其中试验组434例,对照组433例, 其方法学质量均为C级。Meta分析结果显示: 低分子肝素联合依达拉奉注射液组治疗进展性脑梗死的临床疗效显效率、有效率均优于单用低分子肝素组,且差异有统计学意义;其相对危险度及其95%可信区间分别为1.64（1.43,1.88）、0.70（0.55,0.89）。两组治疗前神经功能缺损评分比较差异无统计学意义,治疗后比较,其加权均数差值及其95%可信区间为-5.45（-6.59,-4.31）,差异有统计学意义。两组治疗过程中不良反应发生情况比较差异无统计学意义,其相对危险度及其95%可信区间分别为2.14（0.89,5.14）。 结论 本系统评价结果提示,低分子肝素联合依达拉奉注射液治疗进展性脑梗死疗效优于单用低分子肝素,两组安全性无明显差异。但受到纳入文献质量限制,以上结论尚需高质量的临床试验进一步证实。
    Abstract: Objective To evaluate the efficacy and safety of low molecular weight Heparin（LMWH） combined with Edaravone injection for progressive cerebral infarction（PCI）. Methods Randomized controlled trials （RCTs） of LMWH combined with Edaravone injection treating PCI were identified with CNKI, CBM, VIP, Wanfang, PubMed, MEDLINE, and EMBASE databases up to April 2012, we also scanned references of all included studies and pertinent reviews, compared to LMWH alone for PCI. Every research was evaluated, and then analyzed with Revman 5.0.0 software. Result Eleven randomized controlled trials were included, among total 867 PCI patients, 434 were in trial group and the other 433 were in control group, all evaluation of methodology were graded C. As the meta-analysis showed, the differences of the clinic efficiency rate and effective rate between the two groups were significant, the RR （95%CI） were: 1.64（1.43,1.88）、 0.70（0.55, 0.89）, respectively. The difference was not statistically significant, compared with two groups of treatment of nerve function defect score. After treatment, weighted mean difference and 95%CI were: -5.45（-6.59, -4.31）, the differences were statistically significant. Adverse reactions between the two groups were not statistically significant, its RR and 95%CI were: 2.14 （0.89, 5.14）. Conclusion LMWH combined with Edaravone injection therapy might be more effective than LMWH alone for PCI. However, the results should be interpreted with caution because of the low quality of the included studies. Two groups of security were not significantly different. High-quality, large-scale RCTs are needed to further prove the results.
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  • 收稿日期:  2012-10-22
  • 发布日期:  2013-08-27

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