实用医学杂志 ›› 2021, Vol. 37 ›› Issue (7): 924-930.doi: 10.3969/j.issn.1006⁃5725.2021.07.019

• 药物与临床 • 上一篇    下一篇

法舒地尔联合尼莫地平治疗脑动脉瘤性脑血管痉挛疗效及安全性的Meta分析

谢嵩泉, 赵龙, 彭姝婷, 杨彬彬, 李峥, 张涛, 段军伟, 彭华, 唐晓平    

  1. 川北医学院附属医院神经外科(四川南充 637000)

  • 出版日期:2021-04-10 发布日期:2021-04-10
  • 通讯作者: 唐晓平 E⁃mail:txping1971@163.com
  • 基金资助:

    四川省科技厅科技支撑计划(编号:2015SZ0114); 川北医学院附属医院重点项目(编号:2020ZD018)

The efficacy and safety of fasudil combined with nimodipine in the treatment of cerebral vasospasm caused by cerebral aneurysm:A meta ⁃ analysis

XIE Songquan,ZHAO Long,PENG Shuting,YANG Binbin,LI Zheng,ZHANG Tao,DUAN Junwei,PENG Hua,TANG Xiaoping.   

  1. Department of Neurosurgery,Affiliated Hospi⁃ tal of North Sichuan Medical College,Nanchong 637000,China

  • Online:2021-04-10 Published:2021-04-10
  • Contact: TANG Xiaoping E⁃mail:txping1971@163.com

摘要:

目的 系统评价法舒地尔联合尼莫地平治疗脑动脉瘤性脑血管痉挛的疗效。方法 计算机检索 The Cochrane Library、Embase、PubMed、CNKI、维普、中国生物医学文献数据库和万方等数据库,收集法舒地尔联合尼莫地平治疗脑动脉瘤性脑血管痉挛相关的临床研究,检索时限从建库至 2020 5 月。根据制定的标准对收集的文献进行严格筛选,采用Cochrane 协作网的偏倚风险评估工具进行质量评价,使用 Rev Man 5.3 软件进行 Meta 分析。结果 共纳入 12 项研究,合计样本量 1 146 例。Meta 分析结果显示:与对照组相比,试验组 GCS 评分增加(MD = 2.15,95%CI:1.46 ~ 2.85,P < 0.00 001),Barthel 指数增加 MD = 15.78,95%CI:14.39 ~ 17.18),P < 0.000 01),NFI 评分减少(MD = -2.89,95%CI:-3.91 ~ -1.86,P < 0.000 01),MCA 增加(MD = 12.49,95%CI:7.93 ~ 17.06,P < 0.000 01),差异均有统计学意义;安全性方面,脑梗死发生率降低(OR = 0.24,95%CI:0.13 ~ 0.42,P < 0.000 01)差异具有统计学意义,不良反应发生方面 OR = 1.36,95%CI:0.68 ~ 2.70,P > 0.05)差异无统计学意义。结论 法舒地尔联合尼莫地平治疗脑动脉 瘤性脑血管痉挛疗效较好,且可有效降低脑梗死发生率。

关键词:

Abstract:

Objective To systematically evaluate the efficacy of fasudil in the treatment of refractory hypertension. Methods The Cochrane Library,Embase,PubMed,CNKI,VIP,China Biomedical Literature Database and Wanfang database were searched by computer to collect the clinical studies related to fasudil combined with nimodipine in the treatment of cerebral aneurysmal cerebral vasospasm from the establishment of the database to May 2020. According to the established standards,the collected literature was screened strictly,the bias risk assessment tool of Cochrane collaboration network was used for quality evaluation ,and Rev Man5.3 software was used for Meta analysis. Results Twelve studies with a total sample size of 1 146 people were included. According to the result of Meta⁃analysis:compared with the control group,the GCS score of the test group increased (P < 0.001),the Barthel index increased(P < 0.001),the NFI score decreased(P < 0.001),MCA increased (P < 0.001),the difference was statistically significant. In terms of safety,the incidence of cerebral infarction decreased(P < 0.001),but there was no significant difference in the incidence of adverse reactions(P = 0.38). Conclusion Fasudil combined with nimodipine is effective in the treatment of cerebral vasospasm caused by cere⁃ bral aneurysm,and can effectively reduce the incidence of cerebral infarction.

Key words:

fasudil, nimodipine, cerebral aneurysm, cerebral vasospasm treatment outcome, safety, meta?analysis