CAJ | 학술논문

目的系统评价山莨菪碱对脑复苏神经功能影响的临床疗效及安全性.方法搜索中国期刊全文数据库CNKI(1979年1月至2011年1月)、Pubmed(1978年1月至2011年1月)、The Cochrane Library,搜集山莨菪碱对脑复苏神经功能影响的随机对照试验,按照Cochrane协作网等的相关方法评价纳入文献质量和提取有效数据进行Meta分析.结果共纳入4项研究,包括327例患者.Meta分析结果显示,心肺脑复苏应用山莨菪碱可提高患者早期格拉斯哥昏迷评分(GCS) [MD=1.4,95％CI (0.98,1.82),P＜0.01]及降低中期神经功能缺陷评分(NFI) [MD=-4.38,95％ CI(-5.26,-3.51),P＜0.01]；此外,2项研究提示可降低远期神经功能缺损程度；2项研究提示对于2～3个月患者的生活能力有较大提高；1项研究提示对生活质量(QL)提高有较好作用；1项研究提示其可抑制兴奋性氨基酸释放.所纳入全部研究没有严重不良反映报道.结论山莨菪碱在心肺脑复苏的应用可以促进神经功能恢复,对脑复苏有益且相对安全.
목적 계통평개산랑탕감대뇌복소신경공능영향적림상료효급안전성.방법 수색중국기간전문수거고CNKI(1979년1월지2011년1월)、Pubmed(1978년1월지2011년1월)、The Cochrane Library,수집산랑탕감대뇌복소신경공능영향적수궤대조시험,안조Cochrane협작망등적상관방법평개납입문헌질량화제취유효수거진행Meta분석.결과 공납입4항연구,포괄327례환자.Meta분석결과현시,심폐뇌복소응용산랑탕감가제고환자조기격랍사가혼미평분(GCS) [MD=1.4,95％CI (0.98,1.82),P＜0.01]급강저중기신경공능결함평분(NFI) [MD=-4.38,95％ CI(-5.26,-3.51),P＜0.01]；차외,2항연구제시가강저원기신경공능결손정도；2항연구제시대우2～3개월환자적생활능력유교대제고；1항연구제시대생활질량(QL)제고유교호작용；1항연구제시기가억제흥강성안기산석방.소납입전부연구몰유엄중불량반영보도.결론 산랑탕감재심폐뇌복소적응용가이촉진신경공능회복,대뇌복소유익차상대안전.
Objective To evaluate the clinical effects of Anisodamine on neurological function as well as the safety of using it after cerebral resuscitation. Methods The data of CNKI (from January 1979 through January 2011 ) and Pubmed (from January 1978 through January 2011 ) were searched.The Cochrane Library was applied for identifying randomized controlled trials (RCTs) about effects of Anisodamine on neurological function after cerebral resuscitation.The methodological quality was assessed and the data were collected according to the criteria defined in Cochrane Reviewer' s Handbook for meta-analyses with RevMan 5.0.25 package.Results Data of 327 patients from 4 eligible studies were included in this analysis.The results of meta-analyses showed that Anisodamine used after cerebral resuscitation improved Glasgow coma scale (GCS) in the early stage [ MD =1.4,95％ CI (0.98,1.82),P ＜0.01 ] and lessen neurological deficit (ND) in the later stage [ MD =-4.38,95％CI ( -5.26, -3.51 ),P ＜0.01 ].Meanwhile,the reduction of long-term ND of patients was documented in two studies ; the improvement of ability of daily life of patients in 2 ～ 3 months after anisodamine used was reported in two studies; the improvement of patients' quality of life (QL) was recorded in one study and the inhibited release of excitatory amino acid (EAA) was reported in one study.All eligible studies did not report any serious adverse effects of Anisodamine used after cerebral resuscitation. Conclusions Anisodamine used after cerebral resuscitation can improve patients'status of neurological function with relative safety of administration.