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荟萃分析揭示了维生素B对中风患者的保护作用。

Meta-analysis reveals protective effects of vitamin B on stroke patients.

作者信息

Wang Liping, Cui Weiwei, Nan Guangxian, Yu Yang

机构信息

Department of Neurology, China-Japan Union Hospital, Jilin University, Changchun, Jilin 130033, China.

Department of Nutrition and Food Hygiene, School of Public Health, Jilin University, Changchun, Jilin 130021, China.

出版信息

Transl Neurosci. 2015 Aug 20;6(1):150-156. doi: 10.1515/tnsci-2015-0014. eCollection 2015.

Abstract

Stroke is the loss of brain function due to a disturbance in the blood supply to the brain resulting from either ischemia or hemorrhage. Previous studies have evaluated the clinical importance of nutritional interventions such as vitamin B supplementation in the management of acute strokes. However, it is still inconclusive whether or not vitamin B supplementation will benefit patients with acute strokes. Therefore, a meta-analysis was performed to assess the efficacy of vitamin B supplementation in the treatment of stroke patients. Medline, Embase, Scopus, and Cochrane Library databases were searched (from 1960 to June 2015) and forest plots were generated to illustrate the treatment effects. A systemic review of the electronic databases yielded 12 eligible studies consisting of 7474 patients. Forest plots from the meta-analyses of the included studies illustrated that vitamin B supplementation significantly lowered the plasma concentration of total homocysteine (SMD = -0.82; 95% CI: -0.77; Z = -29.06, p < 0.0001) and resulted in significant reduction in stroke recurrence (OR = 0.86%; 95% CI: 0.76, 0.97; Z = -2.41; p = 0.016) as well as a combined incidence of vascular events, including recurrent strokes, myocardial infarctions and vascular deaths (OR = 0.87%; 95% CI: 0.79, 0.96; Z= -2.73; p = 0.0063). Additionally, the nearly-symmetrical funnel plot (Egger's test, t = -1.705, p = 0.1224) indicated the absence of publication bias regarding the meta-analysis that examined the effect of vitamin B supplementation on the plasma levels of homocysteine in acute stroke patients. These findings suggested that vitamin B supplementation presents a potential addition to the armamentarium for the management of acute stroke patients.

摘要

中风是由于缺血或出血导致脑部血液供应紊乱而引起的脑功能丧失。先前的研究评估了营养干预措施(如补充维生素B)在急性中风管理中的临床重要性。然而,补充维生素B是否会使急性中风患者受益仍尚无定论。因此,进行了一项荟萃分析以评估补充维生素B治疗中风患者的疗效。检索了Medline、Embase、Scopus和Cochrane图书馆数据库(从1960年至2015年6月),并生成森林图以说明治疗效果。对电子数据库进行的系统评价产生了12项符合条件的研究,涉及74,74例患者。纳入研究的荟萃分析森林图表明,补充维生素B可显著降低血浆总同型半胱氨酸浓度(标准化均数差=-0.82;95%置信区间:-0.77;Z=-29.06,p<0.0001),并显著降低中风复发率(比值比=0.86%;95%置信区间:0.76,0.97;Z=-2.41;p=0.016)以及血管事件的综合发生率,包括复发性中风、心肌梗死和血管性死亡(比值比=0.87%;95%置信区间:0.79,0.96;Z=-2.73;p=0.0063)。此外,近乎对称的漏斗图(Egger检验,t=-1.705,p=0.1224)表明,在关于补充维生素B对急性中风患者同型半胱氨酸血浆水平影响的荟萃分析中不存在发表偏倚。这些发现表明,补充维生素B可能是急性中风患者管理手段中的一项潜在补充。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/de29/4936622/9531cb1efae4/tnsci-2015-0014f1.jpg

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