Objective To assess the effectiveness and safety of edaravone for acute cerebral infarction. Methods We searched The Cochrane Central Register of Controlled Trials （ Issue 2, 2005 ）, MEDLINE （ 1966 to Aug. 2005）, EMBASE （ till Aug. 2005 ）, the China Biological Medcine Database （ till Aug. 2005 ）, the Chinese Stroke Clinical Trials Database （ till August 2005 ） and the reference lists of related articles. Two reviewers independently selected studies, assessed quahty of studies and extracted data. The RevMan 4.2 software was used for statistical analysis. Results We identified 12 randomized controlled trials, of which 9 （ n = 948 ） were included. The level of methodology quality was B. Since the conventional therapy was different among some studies, the improvement of disability and long-term death rate and incidence of adverse reactions were not included by meta-analysis. Meta-analysis on the improvement of neurological deficit showed a better effectiveness of edaravone than control with statistical significance [ OR2.98, 95% CI （ 1.39,6.39 ） ]. Possible adverse reactions to edaravone included abnormal liver function and skin rash. Conclusions With relatively poor quality of most included trials and small sample size, insufficient evidence is obtained to support the conclusion that edaravone is safe or effective in the treatment of acute cerebral infarction. Further high quality and large sample randomized controlled trials should be carried out.
目的:研究银杏达莫联合血塞通注射液对急性脑梗死的治疗效果。方法:分成3组,分别为银杏达莫组、血塞通组、银杏达莫联合血塞通治疗组,每组40例。3组给予不同治疗后分别对治疗前及治疗后14、21 d对神经功能缺损及疗效进行评定。结果:银杏达莫组及血塞通组相比,在治疗后第14及21天,银杏达莫联合血塞通组神经功能缺损明显减轻(Plt;005),且疗效更明显(Plt;005)。结论:与银杏达莫组及血塞通组相比,银杏达莫与血塞通联合治疗可更加改善神经功能缺损(Plt;005),并能提高疗效,出血副作用无增加。
目的:初步探讨体外血浆脂蛋白过滤器（DELP）对急性脑梗死患者的临床疗效及安全性。方法:采用随机、基础治疗平行对照试验设计，将符合入选标准的患者随机分为两组:试验组3例，发病48 h内和间隔一天上午接受DELP治疗，对照组2例，仅给予基础治疗。用NIHSS量表，Barthel指数和改良Rankin评分评价神经功能恢复状况。结果:治疗后14 d治疗组NIHSS降低趋势明显优于对照组，治疗后90 d治疗组mRS良好预后的患者比例显著高于对照组。两组均未发现明显不良反应，治疗前后两组的实验室指标无显著变化。结论:DELP治疗急性脑梗死所致的神经功能缺损效果及安全性良好，为临床急性脑梗死的治疗提供了一条新的途径。
Objective To evaluate the effectiveness and safety of edaravone combined with Xingnaojing injection in the treatment of adult acute cerebral infarction. Methods Databases including PubMed, EMbase, The Cochrane Library, CBM, CNKI, VIP and WanFang Data were searched from inception to March 2012 to identify the randomized controlled trials (RCTs) on edaravone combined with Xingnaojing injection for adult acute cerebral infarction. Two reviewers independently selected the literature, extracted the data and assessed the methodological quality of the included RCTs, and then meta-analysis was performed using RevMan 5.0 software. Results A total of 9 RCTs involving 1 098 patients were included. The results of meta-analyses showed: a) The edaravone combined with Xingnaojing injection group was superior to the Xingnaojing injection group with significant differences in the effective rate (OR=3.43, 95%CI 2.44 to 4.82, Plt;0.000 01), significantly-effective rate (OR=2.33, 95%CI 1.78 to 3.05, Plt;0.000 01), mortality (OR=0.38, 95%CI 0.15 to 0.95, P=0.04), ESS score after treatment (7 days after treatment: SMD=–0.48, 95%CI –0.80 to –0.17, P=0.003; 14 days after treatment: SMD=–0.89, 95%CI –1.17 to –0.62, Plt;0.000 01; 1 month after treatment: SMD=–0.89, 95%CI –1.20 to –0.59, Plt;0.000 01) and NDS score after treatment (7 days after treatment: MD=10.42, 95%CI 4.78 to 16.05, P=0.000 3; 14 days after treatment: MD=13.82, 95%CI 12.86 to 14.79, Plt;0.000 01; 21 days after treatment: MD=10.33, 95%CI 4.43 to 16.23, P=0.000 6); and b) The edaravone + Xingnaojing injection + conventional therapy group was superior to the conventional therapy group with significant differences in the effective rate (OR=3.03, 95%CI 1.36 to 6.73, P=0.006), significantly-effective rate (OR=2.86, 95%CI 1.50 to 5.44, P=0.001) and ESS score after treatment (7 days after treatment: MD=–6.26, 95%CI –8.49 to –4.03, Plt;0.000 01; 14 days after treatment: MD=–6.43, 95%CI –8.73 to –4.13, Plt;0.000 01). Conclusion Current evidence shows edaravone combined with Xingnaojing injection is obviously superior to either Xingnaojing injection or conventional therapy for adult acute cerebral infarction. But this conclusion still needs to be further proved by more high-quality and large-scale RCTs because of the low quality of the included studies.
Objective To research on the effect of protoparaxaxotrid saporlirs (PTS), active component in Sanqi Tongshu Capsule, on the expressions of the serum level of IL-6 and VEGF of patients with the acute cerebral infarction at different time points. Method 86 patients were randomly divided into two groups: PTS group and Nimodipine group, healthy person as control group. ELISA was applied to measure the serum level of IL-6 and VEGF in during different phases (3 d, 7 d, 14 d and 28 d after the onset of cerebral infarction). Results The expressions of VEGF rose significantly in the all of ACI patients. The expressions of IL-6 rose significantly on third day, then began to decrease. The serum level of IL-6 declined significantly (Plt;0.05) and the serum level of VEGF rose in both of PTS group and Nimodipine group in contrast with control group (Plt;0.01). Conclusion PTS can promote the expressions of VEGF after the cerebral infarction at different time points, and decrease the expressions of IL-6 in the early period of ACI, decreased，which may be one of the molecular mechanisms of this PTS in treating acute cerebral infarction.
Objective To assess the efficacy and safety of fructose-1,6 diphosphate (FDP) in the treatment of cerebral infarction. Methods We searched MEDLINE, EMbase, Cochrane CENTRAL Register of Controlled Trials, CBM and CNKI in 2006. Randomized controlled trials(RCTs) or quasi-randomized controlled trials involving FDP for cerebral infarction were collected. We assessed the quality of the studies and conducted meta-analyse with The Cochrane Collaboration’s RevMan 4.2. Results Ten RCTs were included, 9 of which were of low quality and only one was graded as high quality. None of the trials reported the number of patients who had died or were dependent at the end of long term follow-up. After 7 to 30 days of treatment, improvement of neurological deficiency was associated with FDP compared with placebo or control [OR 2.45, 95%CI (1.91,3.15)]. There was no statistical difference in the death rate between the FDP and control groups at the end of the treatment [RD –0.01, 95%CI (–0.03,0.01)]. One study found that FDP had a similar safety profile [OR 1.24, 95%CI (0.32,4.75)] to the control group. None of the trials compared the costs in the treatment groups. Conclusions The quality of the published clinical trials on FDP in the treatment of cerebral infarction is poor. FDP may improve short-term neurological deficits, but seems unlikely to decrease mortality. Moreover, we found no evidence to support the long-term efficacy of FDP on mortality, dependency and neurological deficit. Large-scale and high quality clinical trials with sufficient follow-ups are needed to evaluate the role of FDP in the treatment of cerebral infarction.
Objective To assess the effect of naloxone in treating the disease of acute cerebral infarction. Methods Sixty patients of acute cerebral infarction were randomly divided into two groups. One group received routine therapy and the other routine therapy plus naloxone. Neuroprotective effect of naloxone were measured by using NIH stroke scale and Bathel-Index. Adverse effect of the drug was also observed. Results There were 27 patients (90%) improved with clinical manifestations in experiment group, and 20 patients (67%) improved in control group. There is a significant difference between the two groups (Plt;0.05).There is no adverse reactions of naxloxone observed. Conclusion Naloxone might protect the nervous cells and restore the function of the nervous system in patients with acute cerebral infraction.
【摘要】 目的 探讨低场磁共振弥散加权成像（DWI）诊断急性脑梗死的价值。 方法 2007年7月-2009年9月对48例脑梗死患者行常规MRI扫描和DWI，分析不同时期脑梗死的DWI表现。 结果 在发病的超急性期及急性期，DWI病灶显示率均为100.0%，T2WI病灶显示率分别为37.5%、73.7%、100.0%。 结论 低场DWI对急性脑梗死的诊断准确率高，明显优于常规MRI。【Abstract】 Objective To investigate the diagnostic value of diffusion weighted imaging (DWI) in acute cerebral infarction. Methods From July 2007 to September 2009, 48 patients with ischemic stroke underwent conventional MRI and DWI, and the characteristics of DWI were analyzed. Results Abnormal DWI signals were displayed in all patients at hyperacute stage or acute stage, abnormal T2WI signals existed in 37.5%, 73.7%, and 100.0%, respectively. Conclusion DWI in low field MR is highly accurate in diagnosing acute cerebral infarction, which is superior to conventional MRI.