奥拉西坦改善急性脑卒中患者认知功能疗效的Meta分析

目的评价奥拉西坦治疗急性脑卒中患者认知功能的疗效及安全性。方法计算机检索Pubmed、Cochrane图书馆、CNKI、VIP和万方数据库,查找奥拉西坦治疗急性脑卒中患者认知功能的随机对照试验(RCT),同时筛检纳入文献的参考文献。检索时间均从建库至2012年12月。由3名研究者按预定纳入与排除标准筛选文献、提取资料和进行方法学评价质量后,采用Rev Man 5.0软件进行Meta分析。结果共纳入9个RCT。Meta分析结果显示:与安慰剂相比,奥拉西坦在改善急性脑卒中患者简易精神状态检查量表(MMSE)和Barthel指数评分值方面,差异有统计学意义(P<0.05)。8个研究报道了奥拉西坦治疗急性脑卒中的不良反应发生率,与安慰剂组相似,差异无统计学意义(P>0.05),不良反应程度轻微,无严重不良反应发生,临床应用安全。结论奥拉西坦在改善急性脑卒中患者认知功能的疗效肯定且安全性好,受纳入研究质量和数量限制,上述结果尚待更多高质量研究来证实。

Meta-analysis on the Effects of Oxiracetam on the Improvement of Cognition in Patients with Acute Stroke

Objective To assess the clinical efficacy and safety of oxiracetam on the improvement of cognition in patients with acute stroke. Methods Databases such as Pub Med,The Cochrane library,CNKI,VIP and Wanfang Database were searched from the establishment till Dec. 2012,and the references of the included literatures were also searched to collect randomized controlled trials（ RCTs） of oxiracetam on the improvement of cognition in patients with acute stroke. Then the retrieved studies were screened by three reviewers according to the predefined inclusion and exclusion criteria,the data was extracted,the quality of the included studies was evaluated,and meta-analyses were performed by using the Cochrane Collaboraiton＇s Rev Man 5. 0 software. Results Nine RCTs were included in the study. The results of meta-analyses indicated that there were significant differences in the scores of Mini-mental state examination（ MMSE） and Barthel index（ BI） improved by oxiracetam in patients with acute stroke compared with the placebo group（ P 0. 05）.Eight trials reported the incidence of adverse reaction of oxiracetam treatment which showed that no significant difference was found compared with the placebo group and the adverse reaction was mild（ P 0. 05）; in addition,no severe adverse events were reported and the clinical application was safe. Conclusion Oxiracetam is effective and safe in improving the cognition functioning of patients with acute stroke. However,due to the limitation of quality and quantity of the included studies,such conclusion needs to be confirmed by more high quality researches.