依达拉奉右莰醇与神经节苷脂改善急性脑梗死神经功能的间接比较Meta分析  

Meta-Analysis on Indirect Comparison Between Edaravone Dexborneol and Ganglioside in Improving Neurological Function in Acute Cerebral Infarction

作　　者：周梦 张卫芳[3] 张赟 吴方红[2] 祝田田 ZHOU Meng;ZHANG Weifang;ZHANG Yun;WU Fanghong;ZHU Tiantian(School of Pharmacy,Xinxiang Medical University,Henan Xinxiang 453003,China;Dept.of Pharmacy,the People’s Hospital of Anyang City,Henan Anyang 455000,China;Dept.of Pharmacy,the Second Affiliated Hospital of Nanchang University,Nanchang 330006,China)

机构地区：[1]新乡医学院药学院,河南新乡453003 [2]安阳市人民医院药学部,河南安阳455000 [3]南昌大学第二附属医院药学部,南昌330006

出　　处：《中国医院用药评价与分析》2024年第2期242-245,251,共5页Evaluation and Analysis of Drug-use in Hospitals of China

摘　　要：目的:比较依达拉奉右莰醇与神经节苷脂对于急性脑梗死患者神经功能的改善效果。方法:检索PubMed、the Cochrane Library、Embase、中国知网、维普数据库、万方数据库、中国生物医学文献服务系统中建库至2021年12月的临床随机对照试验(观察组干预措施为基础治疗加依达拉奉右莰醇或神经节苷脂,对照组为基础治疗加依达拉奉),采用系统评价的方法对符合纳入标准的研究进行质量评估,采用RevMan 5.4软件对研究结局指标进行直接Meta分析,并利用间接比较法比较依达拉奉右莰醇与神经节苷脂改善急性脑梗死神经功能疗效的差异。结果:纳入7篇研究,共1 741例患者。直接Meta分析结果显示,神经节苷脂、依达拉奉右莰醇改善急性脑梗死患者美国国立卫生研究院脑卒中量表(NIHSS)评分的效果均优于依达拉奉,差异均有统计学意义(依达拉奉右莰醇vs.依达拉奉:MD=-0.36,95%CI=-0.66~-0.07,P=0.02;神经节苷脂vs.依达拉奉:MD=-0.85,95%CI=-1.51~-0.20,P=0.001);在改善Barther指数方面,差异均无统计学意义(依达拉奉右莰醇vs.依达拉奉:RR=1.44,95%CI=0.70~3.00,P=0.32;神经节苷脂vs.依达拉奉:MD=3.73,95%CI=-3.80~11.27,P=0.33)。通过间接比较得知,依达拉奉右莰醇与神经节苷脂改善急性脑梗死患者NIHSS评分的效果比较,差异无统计学意义(MD=-0.324 5,95%CI=-1.203 2~0.618 2,P>0.05)。安全性方面,2项依达拉奉右莰醇相关研究报告治疗过程中出现了严重不良事件,依达拉奉右莰醇与依达拉奉的严重不良事件发生率比较,差异无统计学意义(RR=1.48,95%CI=0.53~4.17,P=0.45);其余研究未发生严重不良事件。结论:目前,有限的证据表明依达拉奉右莰醇与神经节苷脂对于急性脑梗死患者的神经功能均有较好的改善效果,二者差异不显著。但因纳入的研究数量少以及质量不高,故全面评估二者差异尚需更多高质量的直接比较研究。OBJECTIVE:To compare the improvement effect of edaravone dexborneol and ganglioside in improving neurological function in acute ischemic stroke.METHODS:Clinical randomized controlled trials(the observation group was intervened by basic treatment combined with edaravone dexborneol or ganglioside,the control group was given basic treatment combined with edaravone)were retrieved from PubMed,the Cochrane Library,Embase,CNKI,VIP,Wanfang Data,SinoMed from base-building to Dec.2021,systematic review was used to conduct quality assessment on studies met the inclusion criteria,RevMan 5.4 software was used to perform Meta-analysis on the outcome indicators of the studies,indirect comparison method was used to compare the differences in efficacy of improving neurological function in acute cerebral infarction between edaravone dexborneol and ganglioside.RESULTS:A total of 7 studies were enrolled,including 1741 patients.Results of direct Meta-analysis indicated that both ganglioside and edaravone dexborneol had better effect in improving National Institutes of Health Stroke Scale(NIHSS)scores than that of edaravone,with statistically significant differences(edaravone dexborneol vs.edaravone:MD=-0.36,95%CI=-0.66--0.07,P=0.02;ganglioside vs.edaravone:MD=-0.85,95%CI=-1.51--0.20,P=0.001);in terms of improving Barther index,the differences were not statistically significant(edaravone dexborneol vs.edaravone:RR=1.44,95%CI=0.70-3.00,P=0.32;ganglioside vs.edaravone:MD=3.73,95%CI=-3.80-11.27,P=0.33).By indirect comparison,it was known that the difference in the effect of improving NIHSS scores in patients with acute cerebral infarction between edaravone dexborneol and gangliosides was not statistically significant(MD=-0.3245,95%CI=-1.2032-0.6182,P>0.05).In terms of safety,two edaravone dexborneol-related studies reported severe adverse events during treatment,and the difference in the incidence of severe adverse events between edaravone dexborneol and edaravone was not statistically significant(RR=1.48,95%CI=0.53-4.17,P=0.45);no sever

关 键 词：急性脑梗死 依达拉奉右莰醇 神经节苷脂 间接比较 META分析 

分 类 号：R971[医药卫生—药品]