Ma Li, Liu Wei-Guo, Zhang Jian-Min, Chen Gao, Fan Jing, Sheng Han-Song
Department of Neurosurgery, Second Affiliated Hospital, College of Medicine, Zhejiang University, PR China.
Brain Inj. 2010;24(5):730-5. doi: 10.3109/02699051003610516.
Experimental and clinical studies have suggested that magnesium has neuroprotective and vasodilatation properties. A meta-analysis was conducted to assess the effectiveness and safety of intravenous magnesium therapy in patients with aneurysmal subarachnoid haemorrhage (SAH).
Meta-analysis.
Medline, EMBASE and the Cochrane Library were searched for prospective controlled trials evaluating intravenous magnesium for treating SAH after a ruptured aneurysm without language restrictions. Two researchers performed the literature search and data extraction independently.
Six prospective controlled trials involving 699 patients were included in this meta-analysis. Magnesium infusion reduced the risk of poor outcome and delayed cerebral ischemia (DCI): the relative risk was 0.62 (95% confidence interval (CI) 0.46-0.83) and 0.73 (95% CI 0.53-1.00), respectively. Sensitivity analyses were consistent with the meta-analysis. The withdrawal rate for adverse effects was higher in the magnesium-treatment arm compared to the placebo arm, RR 9.98 (95% CI 3.04-32.74).
The meta-analysis suggests that intravenous magnesium therapy reduces the risk of DCI and poor outcome after aneurysmal SAH. Serum magnesium should be routinely monitored for both effectiveness and safety considerations.
实验和临床研究表明镁具有神经保护和血管舒张特性。进行了一项荟萃分析，以评估静脉注射镁疗法对动脉瘤性蛛网膜下腔出血（SAH）患者的有效性和安全性。
荟萃分析。
检索了Medline、EMBASE和Cochrane图书馆，查找评估静脉注射镁治疗动脉瘤破裂后SAH的前瞻性对照试验，无语言限制。两名研究人员独立进行文献检索和数据提取。
本荟萃分析纳入了6项涉及699例患者的前瞻性对照试验。静脉输注镁降低了不良结局和迟发性脑缺血（DCI）的风险：相对风险分别为0.62（95%置信区间（CI）0.46 - 0.83）和0.73（95%CI 0.53 - 1.00）。敏感性分析与荟萃分析结果一致。与安慰剂组相比，镁治疗组的不良反应退出率更高，RR为9.98（95%CI 3.04 - 32.74）。
荟萃分析表明，静脉注射镁疗法可降低动脉瘤性SAH后DCI和不良结局的风险。出于有效性和安全性考虑，应常规监测血清镁水平。
