西洛他唑用于动脉瘤性蛛网膜下腔出血患者疗效的meta分析  

Cilostazol for patients with aneurysmal subarachnoid hemorrhage:a meta-analysis

作　　者：宋锦宁[1] 张斌飞[1] 马旭东[1] 罗显华[1] 白立曦[1] 翟海程[1] 黄廷钦[1] 

机构地区：[1]西安交通大学医学院第一附属医院神经外科,陕西西安710061

出　　处：《中华神经外科疾病研究杂志》2013年第5期400-404,共5页Chinese Journal of Neurosurgical Disease Research

基　　金：国家"863计划"资助项目(2006AA02Z4Z4);教育部新世纪优秀人才支持计划资助项目(NCET-05-0831);陕西省"13115"科技创新工程重大科技专项计划资助项目(2008ZDKG-66)

摘　　要：目的本研究旨在评价西洛他唑用于动脉瘤性蛛网膜下腔出血患者的临床疗效，为其应用提供依据。方法计算机检索西洛他唑用于动脉瘤性蛛网膜下腔出血的对照研究，时间截止2013年1月。由2位研究者独立评价纳人研究的质量、提取数据，统计分析采用RevMan5．2．3软件进行。结果纳入3个研究，共259例患者。Meta分析结果显示：西洛他唑降低症状性脑血管痉挛（RR=0．46；95％CI=0．30～0．71；P=0．0005）、血管造影脑血管痉挛（RR=0．60；95％CI=0．44～0．81；P=0．0008）、血管痉挛性脑梗死（RR=0．38；95％CI：0．22～0．67；P=0．0008）发生率，但不改善短期临床预后（RR=1．28；95％CI=0．98～1．66；P=0．07）。结论西洛他唑可预防动脉瘤性蛛网膜下腔出血后脑血管痉挛、血管痉挛性脑梗死，对患者预后影响还需大样本多中心临床研究进一步证实。Objective To evaluate the effectiveness of cilostazol for patients with aneurysmal subarachnoid hemorrhage, providing the reference for the clinical practice. Methods Systematic literature retrieval was carried out to obtain controlled trials of cilostazol for patients with aneurysmal subarachnoid hemorrhage before January 2013. Methedological quality assessment and data collection were performed by two individual reviewers. A meta-analysis was performed by RevMan 5.2.3 software. Results Three studies, a total of 259 cases of patients, were included. Meta-analysis showed： cilostazol reduced symptomatic cerebral vasospasm （ RR = 0. 46; 95% CI = 0. 30 - 0. 71 ; P =0. 0005）, angiographic vasospasm （ RR = 0. （30; 95% CI = 0. 44 - 0. 81 ; P = 0. 0008）, the incidence cerebral infarction caused by vasospasm （RR =0. 38; 95% CI =0. 22- 0. 67; P = 0. 0008）, but it did not improve the short- term clinical prognosis （RR=l.28; 95% CI =0.98 -1.66; P =0.07）. Conclusion Cilostazol can prevent the cerebral vasospasm and the cerebral infarction caused by vasospasm after aneurysmal subarachnoid hemorrhage. More malticenter clinical trials are needed to confirm the prognosis.

关 键 词：西洛他唑 动脉瘤性蛛网膜下腔出血 META分析 

分 类 号：R651[医药卫生—外科学]