本文選題：腦卒中 + 早期降壓��； 參考：《廣西醫(yī)科大學(xué)》2014年碩士論文

【摘要】：背景：盡管控制高血壓在腦卒中的一級和二級預(yù)防獲益很明確，但是腦卒中后早期降壓的獲益及安全性仍不明確。 目的:評估腦卒中早期降壓是否能改善臨床結(jié)局。 方法：計(jì)算機(jī)檢索Medline、Embase、Cochrane Library、相關(guān)期刊論文（CNKI）、維普中文科技期刊數(shù)據(jù)庫及萬方數(shù)據(jù)庫;同時(shí)手工檢索國內(nèi)相關(guān)領(lǐng)域雜志。納入研究為腦卒中后早期是否降壓的隨機(jī)對照試驗(yàn)，結(jié)局指標(biāo)是死亡/殘疾人數(shù)及不良事件數(shù)。使用Review Manager5.1.4軟件對所提取的數(shù)據(jù)進(jìn)行統(tǒng)計(jì)分析，卡方檢驗(yàn)與I2評價(jià)異質(zhì)性，采用相對危險(xiǎn)度、95%可信區(qū)間、p值描述結(jié)果。 結(jié)果：總共納入8篇隨機(jī)對照試驗(yàn)文獻(xiàn)，試驗(yàn)組5191例患者，，對照組5166例患者。薈萃分析結(jié)果表明：14d的死亡/殘疾結(jié)果比較中，降壓組與對照組死亡/殘疾發(fā)生率差異無統(tǒng)計(jì)學(xué)意義[P=0.75，RR=1.01，95%CI：（0.94,1.09）]。在3m的死亡/殘疾結(jié)果比較中，共納入了7,255例患者，降壓組與對照組死亡/殘疾發(fā)生率差異無統(tǒng)計(jì)學(xué)意義[P=0.23，RR=0.97，95%CI：（0.91,1.02）]。并以年齡＜65y、年齡≥65y、有高血壓病史、無高血壓病史、血壓＜180mmHg、血壓≥180mmHg進(jìn)行亞組分析，結(jié)果提示3m的死亡/殘疾率差異無統(tǒng)計(jì)學(xué)意義。在6m的死亡/殘疾結(jié)果比較中，共納入了2,792例患者，結(jié)果提示降壓組與對照組死亡/殘疾率差異無統(tǒng)計(jì)學(xué)意義[P=0.47，RR=1.04，95%CI：（0.94,1.15）]。3m內(nèi)不良事件的結(jié)果比較中，共納入了3,272例患者，結(jié)果提示降壓組與對照組腦卒中發(fā)生不良事件發(fā)生率差異無統(tǒng)計(jì)學(xué)意義[P=0.90，RR=1.01，95%CI：（0.89,1.14）]。 結(jié)論：目前尚無足夠證據(jù)表明腦卒中后早期降壓能改善或者加重臨床結(jié)局，積極降壓與不降壓安全性相當(dāng)。
[Abstract]:Background: although the benefits of primary and secondary prevention of hypertension control in stroke are clear, the benefits and safety of early hypotension after stroke are unclear. Objective: to evaluate whether early hypotension of stroke can improve the clinical outcome. Methods: Medlinean Embase Cochrane Library, CNKI, Weipu Chinese Science and Technology Journal Database and Wanfang Database were searched by computer, and related domestic journals were searched by hand at the same time. In a randomized controlled trial of early poststroke hypotension, death / disability and adverse events were the outcome indicators. The extracted data were statistically analyzed by Review Manager5.1.4 software. The heterogeneity was evaluated by chi-square test and I2. The results were described by 95% confidence interval of relative risk. Results: a total of 8 articles of randomized controlled trials were included, 5191 patients in the trial group and 5166 patients in the control group. The results of meta-analysis showed that there was no significant difference in mortality / disability rate between the hypotensive group and the control group in the death / disability outcome of 14 days (P < 0. 75). 7255 patients were included in this study. There was no significant difference in the incidence of death / disability between the hypotensive group and the control group. Age < 65yand age 鈮

本文編號：1981017