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目的 系统评价丁苯酞联合依达拉奉对急性脑梗死患者神经功能缺损和独立生活能力的改善,及NSE、SOD和S-100β蛋白的影响。方法 检索PubMed、Medline、中国生物医学文献数据库(CBM)、中国学术期刊全文数据库(CNKI)、维普中文科技期刊数据库(VIP)、万方等数据库,收集丁苯酞联合依达拉奉治疗急性脑梗死的临床随机对照研究(RCT),检索时限2000年1月至2017年5月,采用RevMan 5.2软件进行Meta-分析。结果 纳入11篇RCTs (931例患者)。7篇采用CSS评估神经功能缺损(597例),Meta-分析显示丁苯酞联合依达拉奉改善神经功能优于对照组[MD=-5.17,95% CI(-6.03~-4.30),P<0.01];7篇(593例)采用ADL评估独立生活能力,Meta-分析显示丁苯酞联合依达拉奉改善独立生活能力优于对照组[MD=8.01,95% CI(6.06~9.97),P<0.01]。丁苯酞联合依达拉奉对急性脑梗死患者的NSE水平的下降程度大于对照组[MD=-4.71,95% CI(-5.65~-3.77),P<0.01],S-100β蛋白水平的下降程度大于对照组[MD=-0.40,95% CI(-0.77~-0.22),P<0.01],SOD水平的增加程度大于对照组[MD=13.84,95% CI(11.58~16.10),P<0.01]。结论 丁苯酞联合依达拉奉能有效改善急性脑梗死患者神经功能缺损和独立生活能力,同时提高SOD活性,降低NSE和S-100β蛋白水平。
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[Abstract]
Objective To systematically review improvement of neurological deficits and independent living ability, and effect of NSE, SOD and S-100β of butylphthalide combined with edaravone in patients with acute cerebral infarction.Methods Databases including PubMed, Medline, CBM, CNKI, VIP, and Wanfang were searched to collect randomized controlled trials (RCTs) about butylphthalide combined with edaravone in treatment of patients with acute cerebral infarction from January 2000 to May 2017. Meta-analysis was conducted by RevMan 5.2 software.Results Total of 11 RCTs (n=931) were included. Meta-analysis of seven trials (n=597), in which neurological deficits were assessed by CSS assessment, Meta-analysis showed that the improvement of neurological deficits dosed with butylphthalide combined with edaravone was much better than that in control group[MD=-5.17, 95% CI (-6.03——4.30), P< 0.01], and, the independent living ability in seven trials (n=593) were assessed by ADL, Meta-analysis showed that the improvement of independent living ability treated with butylphthalide combined with edaravone was much better than that in control group[MD=8.01, 95% CI (6.06-9.97), P< 0.01]. Meanwhile Meta-analysis showed that, NSE levels[MD=-4.71, 95% CI (-5.65——3.77), P< 0.01] and S-100β protein level[MD=-0.40, 95% CI (-0.77——0.22), P< 0.01] in patients with acute cerebral infarction dosed with butylphthalide combined with edaravone were much lower than those in control group and, respectively. Which is much higher in SOD level than control group[MD=-0.40, 95% CI(-0.77——0.22), P< 0.01].Conclusion Butylphthalide combined with edaravone can improve the neurological function deficits and independent living ability, increase SOD activity, and reduce the level of NSE and S-100β protein after acute cerebral infarction.
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