摘要
目的:系统评价法舒地尔治疗蛛网膜下腔出血(SAH)后脑血管痉挛(CVS)的有效性和安全性。方法:全面检索Medline(1975-2010)、Cochrane图书馆临床对照试验数据库(1975-2010年)、中国生物医学文献数据库(1978-2010年)、中国期刊全文数据库(1979-2010年)、中文科技期刊数据库(1989-2010年)、万方数字化期刊全文数据库(1985-2010年)中关于法舒地尔治疗SAH后CVS的随机对照试验(RCT)。采用总有效率、CVS发生率、低密度灶发生率评价其有效性;安全性评价包括血压下降发生率、轻微和严重不良反应发生情况。采用RevMan5.0软件进行Meta分析。结果:共纳入22项RCT,包括1288例患者。总有效率法舒地尔30mg,q8h显著优于尼莫地平24mg·d-1,差异有统计学意义[RR=1.14,95%CI(1.03,1.26),P=0.01];法舒地尔30mg,q8h显著优于尼莫地平10mg·d-1,差异有统计学意义[RR=1.30,95%CI(1.11,1.52),P=0.001]。法舒地尔30mg,q8h的CVS发生率低于尼莫地平24mg·d-1,但两者差异无统计学意义[RR=0.78,95%C(I0.51,1.19),P=0.25]。法舒地尔30mg,q8h的低密度灶发生率低于尼莫地平24mg·d-1,但差异无统计学意义[RR=0.62,95%C(I0.27,1.42),P=0.26]。安全性研究显示法舒地尔不良反应少且轻微。结论:应用法舒地尔治疗SAH后CVS能增加总有效率,并降低CVS、低密度灶发生率,且血压下降作用不明显,安全性较好。
OBJECTIVE： To evaluate the effectiveness and safety of fasudil hydrochloride for cerebral vasospasm （CVS） after subarachnoid hemorrhage （SAH）. METHODS： We retrieved from Medline （ 1975-2010）, Cochrane Library Controlled Trials Data- base （1975-2010）, CBMDisc （1979-2010）, CNKI （1979-2010）, VIP （1989-2010） and Wanfang database（1985-2010）. The effectiveness of drug was evaluated with total effective rate, the incidence of cerebral vasospasm and low density focus; safety evalution contained the incidence of BP reduction and slight and severe ADR. Data were analyzed by Rev Man 5.0 software. RESULTS： 22 RCT trials were included, involving 1 288 patients. Total effective rate of fasudil 30 mg, q8h was better than nimodipine 24 mg·d^-1There was statistical significance [RR=1.14, 95%CI（1.03,1.26）, P=0.01]. Fasudil 30 mg, q8h was better than ni-modipine 10mg·d^-1, there was statistical significance [RR=I.30, 95%CI（1.11,1.52）, P=0.001]. The incidence of cerebral vaso- spasm in patients treated with fasudil 30 mg, q8h was lower than nimodipine 24mg·d^-1, there was no statistical significance [RR= 0.78, 95%CI（0.51,1.19）, P=0.25]. The incidence of low density focus in fasudil group （30 mg,q8h） was lower than in nimodipine group （24mg·d^-1）, there was no statistical significance [RR=0.62, 95%CI（0.27,1.42）,P=0.26]. Safety study showed fasudil resulted in few and slighter adverse drag reactions. CONCLUSION： Fasudil can increase effective rate and decrease incidence of cerebral vasospasm and low-density focus in the treatment of cerebral vasospasm after subaractmoid hemorrhage. Fasudil does not decrease blood oressure siznificantly but is safe for treatment.
出处
《中国药房》
CAS
CSCD
2012年第40期3819-3823,共5页
China Pharmacy
