尼莫地平治疗蛛网膜下腔出血的系统评价

目的：系统评价尼莫地平治疗蛛网膜下腔出血的疗效和安全性。方法：计算机检索Cochrane图书馆、Pubmed、EMbase、ISI、中国生物医学文献数据库（CBM）、中国期刊全文数据库（CNKI）、中文科技期刊全文数据库（VIP）、万方数字化期刊全文库以及中国生物医学文献服务系统，纳入尼莫地平与安慰剂治疗蛛网膜下腔出血的随机对照试验（RCT）、系统评价和Meta分析，对纳入的RCT进行方法学质量评价，采用RevMan5．0软件进行系统评价。结果：共纳入8项研究，合计2223例患者。Meta分析结果显示，2组死亡率比较差异无统计学意义RR=0．67，95％CI（0．44，1．03），P=0．07]，尼莫地平组在预防脑缺血方面优于对照组，2组比较差异有统计学意义RR=0．57，95％CI（0．42，0．78），P=0．0004]，2组不良反应发生率比较差异无统计学意义。结论：尼莫地平能够安全、有效地预防蛛网膜下腔出血患者脑缺血的发生，但在降低死亡率方面没有明显的优势。

Nimodipine in the Treatment of Subarachnoid Hemorrhage:a Systematic Review

OBJECTIVE： To evaluate efficacy and safety of nimodipine in the treatment of subarachnoid hemorrhage （SAH）. METHODS：System review, Meta-analysis and random controlled trails （RCT） of nimodipine vs. placebo for SAH were retrieved from Cochrane library, Pubmed, EMbase, ISI, CBM, CNKI, VIP, Wangfang database and Chinese biomedical literature service system. Quality evaluation of included studies was conducted and Meta-analysis was performed using Rev Man5.0 software. RESULTS ： 8 RCTs were included, involving 2 223 patients. Meta-analysis showed that the mortality has no statistical significance in 2 groups RR= 0.67,95 % CI （0.44, 1.03）, P= 0.07]. The prevention of cerebral ischemia of both groups had statistical significance RR= 0.57, 95%CI（0.42, 0.78）], P=0.000 4]. There was no statistical significance in the difference of ADR in 2 groups. CONCLUSION： Nimodipine can effectively prevent the occurrence of cerebral ischemia in patients with subarachnoid hemorrhage. However, nimodipine has no advantage in prevention of mortality.