Department of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden.
J Cereb Blood Flow Metab. 2010 May;30(5):961-8. doi: 10.1038/jcbfm.2009.267. Epub 2009 Dec 30.
Erythropoietin (EPO) has shown promise as a neuroprotectant in animal models of ischemic stroke. EPO is thought not only to protect neurons from cell death, but also to promote regeneration after stroke. Here, we report a systematic review and meta-analysis of the efficacy of EPO in animal models of focal cerebral ischemia. Primary outcomes were infarct size and neurobehavioral outcome. Nineteen studies involving 346 animals for infarct size and 425 animals for neurobehavioral outcome met our inclusion criteria. Erythropoietin improved infarct size by 30.0% (95% CI: 21.3 to 38.8) and neurobehavioral outcome by 39.8% (33.7 to 45.9). Studies that randomized to treatment group or that blinded assessment of outcome showed lower efficacy. Erythropoietin was tested in animals with hypertension in no studies reporting infarct size and in 7.5% of the animals reporting neurobehavioral outcome. These findings show efficacy for EPO in experimental stroke, but when the impact of common sources of bias are considered, this efficacy falls, suggesting we may be overestimating its potential benefit. As common human co-morbidities may reduce therapeutic efficacy, broader testing to delineate the range of circumstances in which EPO works best would be beneficial.
促红细胞生成素（EPO）在缺血性中风的动物模型中显示出作为神经保护剂的潜力。EPO 不仅被认为可以保护神经元免受细胞死亡，而且可以促进中风后的再生。在这里，我们报告了一项促红细胞生成素在局灶性脑缺血动物模型中的疗效的系统评价和荟萃分析。主要结局是梗死面积和神经行为学结果。有 19 项研究符合纳入标准，涉及 346 只用于测量梗死面积的动物和 425 只用于测量神经行为学结果的动物。促红细胞生成素可使梗死面积减少 30.0%（95%CI：21.3 至 38.8），神经行为学结果改善 39.8%（33.7 至 45.9）。随机分组治疗组或对结果进行盲法评估的研究显示疗效较低。在报告梗死面积的研究中，没有研究将促红细胞生成素用于高血压动物，而在报告神经行为学结果的动物中，有 7.5%的动物使用了促红细胞生成素。这些发现表明促红细胞生成素在实验性中风中有疗效，但当考虑常见的偏倚来源的影响时，这种疗效会下降，这表明我们可能高估了它的潜在益处。由于常见的人类合并症可能会降低治疗效果，因此更广泛的测试以确定促红细胞生成素最有效的情况范围将是有益的。
