阿替普酶静脉溶栓对急性缺血性脑卒中神经功能疗效的meta分析

doi:10.3969/j.issn.1006-6233.2021.02.028

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Abstract Objective: To systematically evaluate the efficacy of intravenous thrombolysis with alteplase on patients with acute ischemic stroke. Methods: Electronic database, including CNKI、Wanfang、VIP、CBM、Pubmed、Web of Science、Embase and Cochrane, was systematically search to identify the randomized controlled trial of intravenous thrombolysis intervention for acute ischemic stroke patients. Cochrane Collaboration risk of bias tool was used to assess the quality of included studies. Stata 15.1 and RevMan 5.3 were used to perform data analysis. Results: A total of 28 randomized controlled trial studies (n=2763 patients) were included in the meta-analysis. The results of meta-analysis indicated that compared to control group, intravenous thrombolysis could significantly improve the effective rate (RR:0.95, 95%CI:1.17~1.28, P<0.001)、NIHSS score (SMD:-1.11, 95%CI:-1.41~-0.81, P<0.001)、mRS score (SMD:-0.57, 95%CI:-0.69~-0.45, P<0.001)、BI index (SMD:-0.57, 95%CI:-0.69~-0.45, P<0.001) in patients with acute ischemic stroke. There was no difference in bleeding events between the control group and intravenous thrombolytic therapy(RR:1.18, 95%CI:0.87~1.59, P>0.05).Conclusion: Current evidence suggested that intravenous thrombolysis could significantly improve the neurological deficit in patients with acute ischemic stroke. The above conclusions still need to be further verified by larger sample, high-quality, multi-center randomly controlled trials due to the limit of quality of the included studies.

Key words： Alteplase Intravenous thrombolysis Acute ischemic stroke Meta-analysis Randomly controlled trial

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2021.02.028 OR http://www.hbyxzzs.cn/EN/Y2021/V27/I2/305

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