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目的评价纳洛酮治疗脑梗死的临床疗效和安全性。方法计算机检索MEDLINE(1966—2005-04)、EMBASE(1980—2005-04)、Cochrane临床对照试验资料库(2005年第2期)、中国生物医学文献数据库(1978—2005-04)中所有关于纳洛酮治疗脑梗死的文献,并逐个进行质量评价和资料提取,用RevMan4.2.7进行meta分析。结果共纳入12个随机或半随机对照试验,1075例使用纳洛酮治疗的脑梗死患者。(1)总有效率:5个研究纳洛酮与空白对照比较,显示纳洛酮治疗脑梗死有效,其差异有显著性意义(RR=1.24,95%CI:1.05~1.46)。另有4项研究提示,纳洛酮与低分子右旋糖酐或丹参比较治疗脑梗死,可能提高总有效率;(2)治愈率:纳洛酮与空白对照或低分子右旋糖酐比较,纳洛酮能改善脑梗死患者的治愈率,其差异均有显著性意义(RR=1.54,95%CI:1.09~2.18);(3)不良反应:5个研究报道了其不良反应发生情况,发生数量极少且表现轻微,使用相对安全。结论现有的有限证据表明,纳洛酮相对空白对照,可以提高脑梗死治疗的总有效率及治愈率;但仍需要更多设计良好的随机、双盲、安慰剂对照试验加以证实。
Objective To evaluate the clinical efficacy and safety of naloxone in the treatment of cerebral infarction. Methods The data of MEDLINE (1966-2005-04), EMBASE (1980-2005-04), Cochrane Central Register of Controlled Trials (2005 issue 2) and Chinese Biomedical Literature Database (1978-2005-04) Naloxone treatment of cerebral infarction literature, and one by one quality evaluation and data extraction, using RevMan4.2.7 meta-analysis. Results A total of 12 randomized or quasi-randomized controlled trials were included in 1075 patients with cerebral infarction treated with naloxone. (1) Total Effective Rate: Naloxone compared with blank control in 5 studies showed that naloxone was effective in treating cerebral infarction. The difference was significant (RR = 1.24, 95% CI: 1.05-1.46). Another four studies suggest that naloxone compared with low molecular weight dextran or salvia miltiorrhiza treatment of cerebral infarction, may increase the total effective rate; (2) the cure rate: naloxone compared with the blank control or low molecular weight dextran, naloxone can improve The cure rates of patients with cerebral infarction were significantly different (RR = 1.54, 95% CI: 1.09 ~ 2.18); (3) Adverse reactions: Five studies reported the incidence of adverse reactions, Minor performance, the use of relatively safe. CONCLUSIONS The available limited evidence suggests that naloxone relative to blank controls may improve the overall response rate and cure rate for treatment of cerebral infarction; however, more well-designed randomized, double-blind, placebo-controlled trials are needed to confirm this.