DL-3-n-butylphthalide for acute ischemic stroke: An updated systematic review and meta-analysis of randomized controlled trials.
DL-3-n-butylphthalide for acute ischemic stroke: An updated systematic review and meta-analysis of randomized controlled trials.
复制标题
DL-3-正丁基苯酞治疗急性缺血性中风：随机对照试验的最新系统评价和荟萃分析
DOI：
10.3389/fphar.2022.963118
复制
发表时间：
2022
影响因子：
5.6
通讯作者：
Wang, Deren
中科院分区：
文献类型：
--
作者：
Wang, Huan;Ye, Kaili;Li, Dan;Liu, Yuxin;Wang, Deren
背景：DL-3-正丁基苯酞作为一种神经保护药物在中国被广泛应用于卒中患者。2010年的一项系统审查表明，NBP在促进神经康复方面是安全有效的，但无法得出结论，它是否降低了长期死亡或残疾的风险。自2010年以来，在NBP上进行了大量随机对照试验(RCT)，我们对安全性和有效性数据进行了最新的系统回顾和荟萃分析。方法：我们搜索电子数据库和参考列表，以确定比较接受NBP和未接受NBP(包括安慰剂)的患者的随机对照试验。使用修订的Cochrane Risk of Bias Tool 2.0评估随机对照试验的方法学质量，并使用Review Manager 5.4软件对数据进行荟萃分析。结果：共纳入57项随机对照试验，涉及8747名受试者。20项试验检验了NBP胶囊，29项试验检验了注射，8项试验检验了序贯注射-胶囊疗法。Meta分析显示，NBP治疗与死亡和依赖的综合结局(风险比0.59，95%CI 0.42至0.83；260名参与者；2项研究)、死亡(风险比0.32，95%CI 0.13至0.75；2,287名参与者；10项研究)、修改的Rankin量表评分(平均差异-0.80，95%CI-0.88至-0.72；568名参与者；4项研究)，以及Barthel指数的增加，该指数评估从事日常生活基本活动的能力(平均差异11.08，95%可信区间9.10至13.05；2968参与者；22项研究)。Meta分析发现，根据美国国立卫生研究院卒中量表(平均差值-3.39，95%CI-3.76至-3.03；7.283名参与者；46项研究)和中国卒中量表(平均差值-4.16，95%CI-7.60至-0.73；543名参与者；4项研究)，NBP显著降低了神经功能缺陷。在31个试验中报告的不良事件中，转氨酶升高(发生率1.39-17.53%)、皮疹(0-1.96%)和胃肠道不适(1.09-6.15%)是最常见的不良事件，未见严重不良事件报告。结论：NBP可帮助急性缺血性卒中患者恢复日常生活活动能力，降低神经功能缺失，降低近期死亡率。然而，关于NBP是否降低缺血性卒中后的长期死亡或依赖风险的现有证据仍然不够。
Background: DL -3-n-butylphthalide (NBP) is widely used as a neuroprotective drug in stroke patients in China. A systematic review in 2010 suggested NBP to be safe and effective at promoting neurological recovery, but could not conclude whether it decreased risk of long-term death or disability. Since numerous randomized controlled trials (RCTs) have been conducted on NBP since 2010, we performed an updated systematic review and meta-analysis of safety and efficacy data. Method: We searched electronic databases and reference lists to identify RCTs that compared patients who received NBP or not (including placebo). Methodological quality of RCTs was assessed using the Revised Cochrane Risk of Bias Tool 2.0, and data were meta-analyzed using Review Manager 5.4 software. Results: Fifty-seven RCTs involving 8,747 participants were included. Twenty trials examined NBP as a capsule, 29 as an injection, and 8 as sequential injection-capsule therapy. Meta-analyses showed that NBP treatment was associated with a reduction in composite outcome of death and dependency (risk ratio 0.59, 95% CI 0.42 to 0.83; 260 participants; 2 studies), death (risk ratio 0.32, 95% CI 0.13 to 0.75; 2,287 participants; 10 studies), modified Rankin Scale score (mean difference -0.80, 95% CI -0.88 to -0.72; 568 participants; 4 studies), and an increase in Barthel Index, which assesses the ability to engage in basic activities of daily living (mean difference 11.08, 95% CI 9.10 to 13.05; 2,968 participants; 22 studies). Meta-analyses found that NBP significantly reduced neurological deficit based on National Institute of Health Stroke Scale (mean difference -3.39, 95% CI -3.76 to -3.03; 7.283 participants; 46 studies) and Chinese Stroke Scale (mean difference -4.16, 95% CI -7.60 to -0.73; 543 participants; 4 studies). Of the adverse events reported in 31 trials, elevated transaminase (incidence, 1.39-17.53%), rash (0-1.96%) and gastrointestinal discomfort (1.09-6.15%) were most frequent and no serious adverse events were reported. Conclusion: This update review confirms that NBP can help acute ischemic stroke patients regain the ability to perform activities of daily living, reduce their neurological deficit and short-term death rates. However, the available evidence on whether NBP reduces risk of long-term death or dependence after ischemic stroke remains insufficient.
登录
查看更多内容
急性缺血性卒中的早期意识障碍：发病率、危险因素和结果
影响因子：
2.6
作者：
Li J;Wang D;Tao W;Dong W;Zhang J;Yang J;Liu M
通讯作者：
Liu M
影响因子：
4.8
作者：
Li, Meixi;Meng, Nan;Lv, Peiyuan
通讯作者：
Lv, Peiyuan
影响因子：
3.3
作者：
Li, Jiamin;Liu, Yang;Gao, Xuan
通讯作者：
Gao, Xuan
3D可视化消融规划系统辅助微波消融治疗肝细胞癌（直径>3）：精准临床应用
影响因子：
3.8
作者：
An, Chao;Li, Xin;Liang, Ping
通讯作者：
Liang, Ping
DOI：
10.3390/molecules27010085
发表时间：
2021-12-24
期刊：
Molecules (Basel, Switzerland)
影响因子：
--
作者：
Chen L;Wu C;Xie Z;Sun C;Zhou S
通讯作者：
Zhou S