Meshkini Ali, Meshkini Mohammad, Sadeghi-Bazargani Homayoun
Tabriz University of Medical Sciences (Bio-Medicine), Tabriz, Iran. Email:
J Inj Violence Res. 2017 Jan;9(1):41-50. doi: 10.5249/jivr.v9i1.843. Epub 2017 Jan 1.
Traumatic Brain Injury (TBI) is the leading cause of mortality and morbidity especially in young ages. Despite over 30 years of using Neuroprotective agents for TBI management, there is no absolute recommended agent for the condition yet.
This study is a part of a scoping review thesis on "Neuroprotective agents using for Traumatic Brain Injury: a systematic review & meta-analyses", which had a wide proposal keywords and ran in "Cochrane CENTRAL", "MedLine/PubMed", "SCOPUS", "Thomson Reuters Web of Science", "SID.ir", "Barket Foundation", and "clinicaltrials.gov" databases up to September 06, 2015. This study limits the retrieved search results only to those which used citicoline for TBI management. The included Randomized Clinical Trials' (RCTs) were assessed for their quality of reporting by adapting CONSORT-checklist prior to extracting their data into me-ta-analysis. Meta-analyses of this review were conducted by Glasgow Outcome Scale (GOS) in acute TBI patients and total neuropsychological assessments in both acute and chronic TBI management, mortalities and adverse-effects.
Four RCTs were retrieved and included in this review with 1196 participants (10 were chronic TBI impaired patients); the analysis of 1128 patients for their favorable GOS outcomes in two studies showed no significant difference between the study groups; however, neuropsychological outcomes were significantly better in placebo/control group of 971 patients of three studies. Mortality rates and adverse-effects analysis based on two studies with 1429 patients showed no significant difference between the study groups. However, two other studies have neither mortality nor adverse effects reports due to their protocol.
Citicoline use for acute TBI seems to have no field of support anymore, whereas it may have some benefits in improving the neuro-cognitive state in chronic TBI patients. It's also recommended to keep in mind acute interventions like Psychological First Aid (PFA) during acute TBI management.
创伤性脑损伤（TBI）是导致死亡和发病的主要原因，尤其是在年轻人中。尽管使用神经保护剂治疗TBI已有30多年，但目前尚无绝对推荐用于该病症的药物。
本研究是关于“用于创伤性脑损伤的神经保护剂：系统评价与荟萃分析”的范围综述论文的一部分，该综述有广泛的关键词，并在“Cochrane CENTRAL”、“MedLine/PubMed”、“SCOPUS”、“汤森路透Web of Science”、“SID.ir”、“巴克特基金会”和“clinicaltrials.gov”数据库中进行检索，截至2015年9月6日。本研究仅将检索到的结果限制为那些使用胞磷胆碱治疗TBI的研究。在将纳入的随机临床试验（RCT）数据提取到荟萃分析之前，通过采用CONSORT清单评估其报告质量。本综述的荟萃分析通过格拉斯哥预后量表（GOS）对急性TBI患者进行，以及对急性和慢性TBI治疗中的全神经心理学评估、死亡率和不良反应进行。
检索到四项RCT并纳入本综述，共有1196名参与者（10名是慢性TBI受损患者）；两项研究中对1128名患者的良好GOS结果分析显示，研究组之间无显著差异；然而，三项研究中971名患者的安慰剂/对照组的神经心理学结果明显更好。基于两项研究中1429名患者的死亡率和不良反应分析显示，研究组之间无显著差异。然而，另外两项研究由于其方案，既没有死亡率报告也没有不良反应报告。
胞磷胆碱用于急性TBI似乎不再有支持依据，而在改善慢性TBI患者的神经认知状态方面可能有一些益处。还建议在急性TBI治疗期间牢记诸如心理急救（PFA）等急性干预措施。
