Efficacy and safety of therapies for acute ischemic stroke in China: a network meta-analysis of 13289 patients from 145 randomized controlled trials.
Efficacy and safety of therapies for acute ischemic stroke in China: a network meta-analysis of 13289 patients from 145 randomized controlled trials.
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DOI：
10.1371/journal.pone.0088440
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发表时间：
2014
期刊：
影响因子：
3.7
通讯作者：
Sun H
中科院分区：
文献类型：
--
作者：
Yang B;Shi J;Chen X;Ma B;Sun H
其中许多疗法已与安慰剂进行了比较，但尚未直接相互比较。直接或间接评估几种常用药物治疗 AIS 的疗效和安全性。我们进行了系统性文献综述，以确定 2013 年 4 月之前发表的 AIS 治疗随机对照试验 (RCT)。主要结局指标是美国国立卫生研究院卒中量表（NIHSS）评分和临床有效率。进行固定效应荟萃分析和荟萃回归；最后，通过贝叶斯方法进行混合处理比较。急性缺血性中风治疗的疗效结果如下： 上述所有治疗均比安慰剂奥扎格雷钠更有效（RR 3.86，95% CI 3.18-4.61）；奥扎格雷钠+依达拉奉（RR 9.60，95%CI 7.04–13.06）；依达拉奉（RR 4.07，95%CI 3.30–5.01）；依达拉奉 + 激肽原酶（RR 15.33，95% CI 10.03–23.05）。依达拉奉单药治疗与奥扎格雷钠+依达拉奉之间的疗效存在显着差异（RR 0.43，95%CI 0.08-0.61），依达拉奉+激肽原酶与奥扎格雷钠的疗效之间也存在显着差异（RR 4.00，95%CI 2.47-6.24）。比较奥扎格雷钠和依达拉奉或依达拉奉 + 激肽原酶和奥扎格雷钠 + 依达拉奉治疗 AIS 时，风险和获益之间的差异并不显着。神经功能缺陷的结果：与奥扎格雷钠（WMD = −3.11，95%CI -4.43至-1.79）、奥扎格雷钠+依达拉奉（WMD = −6.25，95%CI -7.96至-4.54）和依达拉奉相比，安慰剂在治疗神经功能缺陷方面有显着差异。 + 激肽原酶（WMD = -3.47，95%CI -5.73 至 -1.21）。规定依达拉奉单药治疗的疗效并不优于奥扎格雷钠+依达拉奉。依达拉奉+激肽原酶单药治疗的疗效优于奥扎格雷钠。依达拉奉 + 激肽原酶和奥扎格雷钠 + 依达拉奉是最有效的治疗方法。而奥扎格雷钠、奥扎格雷钠+依达拉奉、依达拉奉+激肽原酶可改善神经功能障碍。
Many of these therapies have been compared against placebos, but have not been directly compared against each other. To evaluate the efficacy and safety of several commonly used drugs for AIS directly or indirectly. A systematic literature review was performed to identify randomized controlled trials (RCTs) published prior to April 2013 for AIS therapies. The primary outcome measures were the National Institutes of Health Stroke Scale (NIHSS) scores and the clinical effective rate. A fixed-effects meta-analysis and meta-regression are performed; lastly, performed a mixed treatment comparison was performed through the Bayesian methods. Outcome of Efficacy of therapies for acute ischemic stroke are as followed: All of the therapies mentioned above yielded results a more effective result than placebo, Sodium ozagrel (RR 3.86, 95%CI 3.18–4.61); Sodium ozagrel + edaravone (RR 9.60, 95%CI 7.04–13.06); Edaravone (RR 4.07, 95%CI 3.30–5.01); Edaravone + Kininogenase (RR 15.33, 95%CI 10.03–23.05). The significant difference in efficacy between edaravone monotherapy and Sodium ozagrel + edaravone was evident (RR 0.43, 95%CI 0.08–0.61) and was also significant between efficacy of edaravone + Kininogenase and Sodium ozagrel (RR 4.00, 95%CI 2.47–6.24). The differences between the risk and benefit were not significant when comparing Sodium ozagrel and edaravone or edaravone + Kininogenase and Sodium ozagrel + Edaravone for AIS. Outcome of the defect of neurological function: Placebo served a significant difference in treating the defects of neurological function compared with Sodium ozagrel (WMD = −3.11, 95%CI −4.43 to −1.79), Sodium ozagrel + edaravone (WMD = −6.25, 95%CI −7.96 to −4.54) and Edaravone + Kininogenase (WMD = −3.47, 95%CI −5.73 to −1.21). It provides that the efficacy of edaravone monotherapy in treatment was not more effective than Sodium ozagrel + edaravone.The efficacy of edaravone + Kininogenase monotherapy in treatment was more effective than Sodium ozagrel. Edaravone + Kininogenase and Sodium ozagrel + Edaravone appeared the most effective treatments. And Sodium ozagrel, Sodium ozagrel + edaravone, Edaravone + Kininogenase can improve the nerve dysfunction.
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影响因子：
9.9
作者：
Adams, HP;Davis, PH;Hansen, MD
通讯作者：
Hansen, MD
影响因子：
4
作者：
Jansen JP
通讯作者：
Jansen JP
影响因子：
2
作者：
Lumley, T
通讯作者：
Lumley, T
影响因子：
4.5
作者：
Jansen, Jeroen P.;Crawford, Bruce;Stam, Wiro
通讯作者：
Stam, Wiro
DOI：
10.1016/0197-2456(95)00134-4
发表时间：
1996-02-01
期刊：
CONTROLLED CLINICAL TRIALS
影响因子：
--
作者：
Jadad, AR;Moore, RA;McQuay, HJ
通讯作者：
McQuay, HJ