山莨菪碱对脑复苏神经功能影响的系统评价  

Effects of anisodamine on neurological functional status of cerebral resuscitation ： a systematic review andmeta-analysis

作　　者：刘京铭[1] 武岩[2] 刘严[2] 王静[2] 王昆[2] 荆华[2] 

机构地区：[1]北京市结核病胸部肿瘤研究所首都医科大学附属北京胸科医院结核二科,北京100049 [2]清华大学玉泉医院急诊科,北京100049

出　　处：《中华急诊医学杂志》2012年第1期28-32,共5页Chinese Journal of Emergency Medicine

摘　　要：目的系统评价山莨菪碱对脑复苏神经功能影响的临床疗效及安全性。方法搜索中国期刊全文数据库CNKI（1979年1月至2011年1月）、Pubmed（1978年1月至2011年1月）、TheCochraneLibrary，搜集山莨菪碱对脑复苏神经功能影响的随机对照试验，按照Cochrane协作网等的相关方法评价纳入文献质量和提取有效数据进行Meta分析。结果共纳入4项研究，包括327例患者。Meta分析结果显示，心肺脑复苏应用山莨菪碱可提高患者早期格拉斯哥昏迷评分（GCS）[MD=1．4，95％CI（0．98，1．82），P〈0．01]及降低中期神经功能缺陷评分（NFI）[MD=-4．38，95％CI（-5．26，-3．51），P〈0．01]；此外，2项研究提示可降低远期神经功能缺损程度；2项研究提示对于2—3个月患者的生活能力有较大提高；1项研究提示对生活质量（QL）提高有较好作用；1项研究提示其可抑制兴奋性氨基酸释放。所纳入全部研究没有严重不良反映报道。结论山莨菪碱在心肺脑复苏的应用可以促进神经功能恢复，对脑复苏有益且相对安全。Objective To evaluate the clinical effects of Anisodamine on neurological function as well as the safety of using it after cerebral resuscitation. Methods The data of CNKI （from January 1979 through January 2011 ） and Pubmed （from January 1978 through January 2011 ） were searched. The Cochrane Library was applied for identifying randomized controlled trials （ RCTs ） about effects of Anisodamine on neurological function after cerebral resuscitation. The methodological quality was assessed and the data were collected according to the criteria defined in Cochrane Reviewer＇ s Handbook for meta-analyses with RevMan 5.0. 25 package. Results Data of 327 patients from 4 eligible studies were included in this analysis. The results of meta-analyses showed that Anisodamine used after cerebral resuscitation improved Glasgow coma scale （GCS） in the early stage [ MD = 1.4, 95% CI （0. 98, 1.82）, P 〈0. 01 ~ and lessen neurological deficit （ND） in the later stage [ MD = -4. 38, 95% CI （ -5.26, -3.51 ）, P 〈 0. 01 ]. Meanwhile, the reduction of long-term ND of patients was documented in two studies ; the improvement of ability of daily life of patients in 2 - 3 months after anisodamine used was reported in two studies; the improvement of patients＇ quality of life （QL） was recorded in one study and the inhibited release of excitatory amino acid （EAA） was reported in one study. All eligible studies did not report any serious adverse effects of Anisodamine used after cerebral resuscitation. Conclusions Anisodamine used after cerebral resuscitation can improve patients＇status of neurological function with relative safety of administration

关 键 词：山莨菪碱 脑复苏 神经功能 系统评价 META分析 

分 类 号：R459.7[医药卫生—急诊医学]