用于急性缺血性卒中的茶碱、氨茶碱、咖啡因及类似物。
Theophylline, aminophylline, caffeine and analogues for acute ischaemic stroke.
作者信息
Bath P M W
机构信息
Division of Stroke Medicine, University of Nottingham, City Hospital Campus, Hucknall Road, Nottingham, Nottinghamshire, UK, NG5 1PB.
出版信息
Cochrane Database Syst Rev. 2004;2004(3):CD000211. doi: 10.1002/14651858.CD000211.pub2.
BACKGROUND
Theophylline causes potent cerebral vasoconstriction which decreases blood flow in the non-ischaemic areas of the brain and increases collateral blood flow surrounding the ischaemic region. NOTE: This review covers an area where no active research is taking place. It will be updated if relevant information becomes available, e.g. on completion of an appropriate study.
OBJECTIVES
The objective of this review was to assess the effect of theophylline and its analogues, aminophylline and caffeine, in people with confirmed or presumed acute ischaemic stroke.
SEARCH STRATEGY
We searched the Cochrane Stroke Group Trials Register (last searched November 2003). For the first version, we also searched EMBASE (1980 to 1999), MEDLINE (1966 to 1999) and Science Citation Index (1981 to 1999). We also contacted the principal investigators of the identified trials.
SELECTION CRITERIA
Randomised trials of theophylline or an analogue compound compared with placebo or control in people with confirmed or presumed acute ischaemic stroke. Trials were included if treatment was started within one week of stroke onset.
DATA COLLECTION AND ANALYSIS
Three reviewers applied the inclusion criteria, assessed trial quality and extracted data for the first version. The review was updated by one reviewer.
MAIN RESULTS
Two trials involving just 119 patients were included; 6 studies were excluded. Trial quality was good. Both of the trials tested aminophylline. Analysis was by intention-to-treat where possible. No significant difference was shown in early case fatality (within four weeks) between aminophylline and placebo although the confidence intervals were wide (odds ratio [OR] 1.12, 95% confidence interval [CI] 0.49 to 2.56). There was no significant difference for early death and deterioration (OR 0.87, 95% CI 0.41 to 1.88). Death or disability was not significantly reduced by treatment based on 73 patients in one trial (OR 0.64, 95% CI 0.24 to 1.68). Data for late death and disability were not in a form suitable for analysis. No data on quality of life were available.
REVIEWERS' CONCLUSIONS: There is not enough evidence to assess whether theophylline or its analogues, e.g. aminophylline, are safe and improve outcome in people with acute ischaemic stroke.
背景
茶碱可引起强烈的脑血管收缩，减少大脑非缺血区域的血流，并增加缺血区域周围的侧支血流。注意：本综述涵盖的领域目前没有正在进行的积极研究。如有相关信息可用，例如适当研究完成后，将对其进行更新。
目的
本综述的目的是评估茶碱及其类似物氨茶碱和咖啡因对确诊或疑似急性缺血性卒中患者的影响。
检索策略
我们检索了Cochrane卒中小组试验注册库（最后检索时间为2003年11月）。对于第一版，我们还检索了EMBASE（1980年至1999年）、MEDLINE（1966年至1999年）和科学引文索引（1981年至1999年）。我们还联系了已识别试验的主要研究者。
入选标准
在确诊或疑似急性缺血性卒中患者中，将茶碱或类似化合物与安慰剂或对照进行比较的随机试验。如果在卒中发作后一周内开始治疗，则纳入试验。
数据收集与分析
三位评审员应用纳入标准，评估试验质量，并为第一版提取数据。该综述由一位评审员更新。
主要结果
纳入了两项仅涉及119名患者的试验；排除了6项研究。试验质量良好。两项试验均测试了氨茶碱。尽可能采用意向性分析。氨茶碱与安慰剂在早期病死率（四周内）方面未显示出显著差异，尽管置信区间较宽（比值比[OR]1.12，95%置信区间[CI]0.49至2.56）。早期死亡和病情恶化方面也无显著差异（OR 0.87，95%CI 0.41至1.88）。一项试验中基于73名患者的数据显示，治疗并未显著降低死亡或残疾风险（OR 0.
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