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[摘要]
目的 系統(tǒng)評價丁苯酞聯(lián)合依達拉奉對急性腦梗死患者神經(jīng)功能缺損和獨立生活能力的改善,及NSE、SOD和S-100β蛋白的影響。方法 檢索PubMed、Medline、中國生物醫(yī)學文獻數(shù)據(jù)庫(CBM)、中國學術期刊全文數(shù)據(jù)庫(CNKI)、維普中文科技期刊數(shù)據(jù)庫(VIP)、萬方等數(shù)據(jù)庫,收集丁苯酞聯(lián)合依達拉奉治療急性腦梗死的臨床隨機對照研究(RCT),檢索時限2000年1月至2017年5月,采用RevMan 5.2軟件進行Meta-分析。結果 納入11篇RCTs (931例患者)。7篇采用CSS評估神經(jīng)功能缺損(597例),Meta-分析顯示丁苯酞聯(lián)合依達拉奉改善神經(jīng)功能優(yōu)于對照組[MD=-5.17,95% CI(-6.03~-4.30),P<0.01];7篇(593例)采用ADL評估獨立生活能力,Meta-分析顯示丁苯酞聯(lián)合依達拉奉改善獨立生活能力優(yōu)于對照組[MD=8.01,95% CI(6.06~9.97),P<0.01]。丁苯酞聯(lián)合依達拉奉對急性腦梗死患者的NSE水平的下降程度大于對照組[MD=-4.71,95% CI(-5.65~-3.77),P<0.01],S-100β蛋白水平的下降程度大于對照組[MD=-0.40,95% CI(-0.77~-0.22),P<0.01],SOD水平的增加程度大于對照組[MD=13.84,95% CI(11.58~16.10),P<0.01]。結論 丁苯酞聯(lián)合依達拉奉能有效改善急性腦梗死患者神經(jīng)功能缺損和獨立生活能力,同時提高SOD活性,降低NSE和S-100β蛋白水平。
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[Abstract]
Objective To systematically review improvement of neurological deficits and independent living ability, and effect of NSE, SOD and S-100β of butylphthalide combined with edaravone in patients with acute cerebral infarction.Methods Databases including PubMed, Medline, CBM, CNKI, VIP, and Wanfang were searched to collect randomized controlled trials (RCTs) about butylphthalide combined with edaravone in treatment of patients with acute cerebral infarction from January 2000 to May 2017. Meta-analysis was conducted by RevMan 5.2 software.Results Total of 11 RCTs (n=931) were included. Meta-analysis of seven trials (n=597), in which neurological deficits were assessed by CSS assessment, Meta-analysis showed that the improvement of neurological deficits dosed with butylphthalide combined with edaravone was much better than that in control group[MD=-5.17, 95% CI (-6.03——4.30), P< 0.01], and, the independent living ability in seven trials (n=593) were assessed by ADL, Meta-analysis showed that the improvement of independent living ability treated with butylphthalide combined with edaravone was much better than that in control group[MD=8.01, 95% CI (6.06-9.97), P< 0.01]. Meanwhile Meta-analysis showed that, NSE levels[MD=-4.71, 95% CI (-5.65——3.77), P< 0.01] and S-100β protein level[MD=-0.40, 95% CI (-0.77——0.22), P< 0.01] in patients with acute cerebral infarction dosed with butylphthalide combined with edaravone were much lower than those in control group and, respectively. Which is much higher in SOD level than control group[MD=-0.40, 95% CI(-0.77——0.22), P< 0.01].Conclusion Butylphthalide combined with edaravone can improve the neurological function deficits and independent living ability, increase SOD activity, and reduce the level of NSE and S-100β protein after acute cerebral infarction.
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