Systematic assessment and meta-analysis of the efficacy and safety of fasudil in the treatment of cerebral vasospasm in patients with subarachnoid hemorrhage
Systematic assessment and meta-analysis of the efficacy and safety of fasudil in the treatment of cerebral vasospasm in patients with subarachnoid hemorrhage
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DOI：
10.1007/s00228-011-1100-x
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发表时间：
2012-02-01
影响因子：
2.9
通讯作者：
Zeng, Yan Jun
中科院分区：
文献类型：
--
作者：
Liu, Guang Jian;Wang, Zheng Jun;Zeng, Yan Jun
脑血管痉挛（CVS）是蛛网膜下腔出血（SAH）患者常见且不可预测的并发症，通常会导致不良预后。本研究旨在评价法舒地尔治疗SAH患者CVS的有效性和安全性。通过中国科技期刊全文数据库、万方数据库（1999年1月至2010年11月）、中华医学会数字期刊数据库、PubMed、Cochrane图书馆、OVID和EMBase（检索至2010年11月）进行检索，共有8项研究符合纳入标准。法舒地尔组患者中症状性CVS和经血管造影证实的CVS发生率分别仅为48%（比值比[OR] = 0.48，95%置信区间[CI]：0.32-0.72，P = 0.0005）和40%（OR = 0.40，95% CI：0.24-0-67，P = 0.0004）分别为对照组。法舒地尔组所有病例发生脑梗死和CVS病例发生脑梗死的比值比分别仅为50%（OR = 0.50，95% CI：0.34-0.76，P = 0.0009）和43%（OR = 0.43，95% CI：0.26-0.70，P = 0.0008）。法舒地尔大大减少SAH患者CVS和脑梗塞的发生，显着改善患者的临床结局（按照格拉斯哥结局量表评估）。由于可供分析的试验和样本数量有限，本研究的结论仍需要通过大型随机对照临床试验的结果进行验证。
Cerebral vasospasm (CVS) is a frequent and unpredictable complication in patients with subarachnoid hemorrhage (SAH) and often leads to poor outcomes. This study was aimed at evaluating the efficacy and safety of fasudil in the treatment of CVS in patients with SAH.A search was conducted using the full-text database of Chinese scientific journals, the Wanfang Database (January 1999 to November 2010), the Chinese Medical Association Digital Journal Database, PubMed, the Cochrane library, OVID, and EMBase (searching through November 2010).A total of 8 studies met the inclusion criteria. The incidence rates of symptomatic CVS and CVS confirmed by angiography among the patients in the fasudil group were only 48% (odds ratio [OR] = 0.48, 95% confidence interval [CI]: 0.32-0.72, P = 0.0005) and 40% (OR = 0.40, 95% CI: 0.24-0-67, P = 0.0004) respectively of that of the control group. The odds ratios of cerebral infarction for all cases and cerebral infarction for CVS cases in the fasudil group were only 50% (OR = 0.50, 95% CI: 0.34-0.76, P = 0.0009) and 43% (OR = 0.43, 95% CI: 0.26-0.70, P = 0.0008) respectively of that of the control group.Fasudil greatly reduces the occurrence of CVS and cerebral infarction in SAH patients, significantly improves the clinical outcomes of the patients (as assessed by the Glasgow Outcome Scale). Because of the limited number of trials and samples available for analysis, the conclusions from the present study still need to be validated with results from large randomized, controlled clinical trials.