兰州大学机构库 >学院待认领
他汀类药物预防卒中再发的系统评价
Alternative TitleStatin for preventing stroke recurrence:A systematic review
郭佳
Thesis Advisor石正洪
2009-05-26
Degree Grantor兰州大学
Place of Conferral兰州
Degree Name硕士
Keyword卒中 再发 他汀类药物 系统评价
Abstract目的 系统评价他汀类药物预防脑卒中再发的临床疗效。 方法 计算机检索Cochrane Library(2008年第1期)、PubMed(1966~2008.5)、 EMBASE(1974~2008.5)、CBM(1978~2008.5)、CSJD(1989~2008.5)、CJFD(1994~2008.5)等数据库;Google、 Medical Martix等互联网上资源;手工检索《临床神经病学杂志》(2008.5.13)、《中风与神经疾病杂志》(2008.5.13)、《中国临床神经科学》(2008.5.14)和《中华神经科杂志》(2008.5.15),并追踪检索纳入文献的参考文献和灰色文献,收集全世界关于他汀类药物预防卒中再发的随机对照试验(2008.5.10)。由两名研究者独立提取资料,根据Cochrane Handbook 4.2.6质量评价标准进行评价,用RevMan5.0进行统计学分析。各研究间有统计学同质性采用固定效应模型,如各研究间存在统计学异质性采用随机效应模型。若异质性源于低质量研究,则进行敏感性分析。计数资料采用相对危险度(RR)为疗效分析统计量;计量资料采用加权均数差(WMD)或标准化均数差(SMD);各效应量均以95%可信区间(CI)表示。 结果 共纳入6个随机对照试验(9675例)。Meta分析结果显示:与安慰剂相比,他汀类药物在卒中复发率[RR 0.94,95%CI (0.84,1.04),P=0.21]、致死性卒中发生率[RR 0.77,95%CI (0.48,1.25),P=0.30]方面无统计学差异,非致死性卒中发生率差异无统计学意义[RR 0.91,95%CI (0.79,1.05),P=0.20],在短暂性脑缺血发作发生率[RR=0.80,95%CI (0.69,0.92),P=0.002]方面有统计学差异,缺血性卒中发生率差异有统计学意义[RR 0.80,95%CI (0.70,0.92),P=0.002],出血性卒中发生率差异有统计学意义[RR 1.73,95%CI (1.19,2.49),P=0.004]。 结论 当前证据表明,他汀类药物预防卒中再发、致死性卒中发生率效果不佳,但可预防短暂性脑缺血发作(TIA)。
Other AbstractObjective To assess the clinical efficacy of statin for preventing stroke recurrence in the world. Method The following databases were searched: EMBASE(1974-2006.12),Cochrane library(1 issue,2008),PubMed(1956-2008.5),Chinese Biomedical Literature Database (CBM)(1978-2008.5),Chinese Scientific Journals Fulltext Database(CSJD)¬(1989-2008.5) and China Journal Fulltext Database(CJFD)(1994-2008.5).et al;Web information of unpublished trials were identified by hand-searching reference lists and abstracts of conference proceedings and google and medical Martix;We handsearched some important Chinese journals. In addition, we tracked down the reference lists of papers related. Two reviewers independently assessed the methodological quality of studies and extracted data.We included randomized controlled trials which adopted statin versus placebo for stroke; we assessed the RCTs methodological quality by randomization method, allocation concealment, blinding.Data were processed by Revman 5.0. We estimated studies of heterogeneity by random effects model, we estimated studies of noheterogeneity by fixed effects model, if the heterogeneity caused by low quality studies, we would processed by sensitivity analysis.Dichotomousoutcome results were expressed as relative risk (RR). Continuous outcomes were expressed as weighted mean difference (WMD) and standard mean difference(SMD), both with 95% confidence intervals (CI). Result Six randomized controlled trials totaling 9675 patients were included The results of meta-analysis were as follows: There is no statistical difference in stroke recurrence rate [RR 0.94, 95%CI (0.84, 1.04), P=0.21], fatal stroke occurrence [RR 0.77, 95%CI (0.48, 1.25), P=0.30], non-fatal stroke occurrence [RR 0.91,95%CI (0.79,1.05),P=0.20], ischaemic stroke occurrence [RR 0.80,95%CI (0.70,0.92),P=0.002] between statin group and placebo group, but a significant difference was found between the two groups in TIA occurrence[RR=0.80, 95%CI (0.69, 0.92), P=0.002] and haemorrhage stroke occurrence[RR 1.73,95%CI (1.19,2.49),P=0.004]. Conclusion Current evidence indicates that statin drugs have no superiority to prevent stroke recurrence and fatal stroke occurence, but can prevent transient ischemic attack (TIA).
URL查看原文
Language中文
Document Type学位论文
Identifierhttps://ir.lzu.edu.cn/handle/262010/222669
Collection学院待认领
Affiliation临床医学院
Recommended Citation
GB/T 7714
郭佳. 他汀类药物预防卒中再发的系统评价[D]. 兰州. 兰州大学,2009.
Files in This Item:
There are no files associated with this item.
Related Services
Recommend this item
Bookmark
Usage statistics
Export to Endnote
Altmetrics Score
Google Scholar
Similar articles in Google Scholar
[郭佳]'s Articles
Baidu academic
Similar articles in Baidu academic
[郭佳]'s Articles
Bing Scholar
Similar articles in Bing Scholar
[郭佳]'s Articles
Terms of Use
No data!
Social Bookmark/Share
No comment.
Items in the repository are protected by copyright, with all rights reserved, unless otherwise indicated.