Yu Zhang, Ling Liu
Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Department of Neurology, Chengdu Shangjin Nanfu Hospital, Chengdu, Sichuan, China.
Int J Neurosci. 2023 Jun;133(6):621-628. doi: 10.1080/00207454.2021.1953020. Epub 2021 Aug 11.
Evidence-based medicine was used to evaluate the efficacy and safety of tranexamic acid in patients with intracerebral hemorrhage.
Pubmed (MEDLINE), Embase, and Cochrane Library were searched from January 2001 to October 2020 for randomized controlled trials (RCTs), cohort studies, and retrospective case series .The Jadad scale and RevMan software version 5.3 were used for literature quality assessment and meta-analysis.
In total, 4 randomized controlled trials and 1 retrospective case series with 2808 participants were included in the meta-analysis. Compared with control intervention in intracerebral hemorrhage, tranexamic acid could significantly reduce growth of hemorrhagic mass (odds ratio (OR) =0.81; 95% confidence interval(CI)=0.68 to 0.99; = 0.04) and Modified Rankin Scale score (MRS) at 90 days at 0-3 (OR = 1.20; 95% CI = 1.00 to 1.43; = 0.05), mortality by day 90 (OR= 1.03; 95% CI= 0.85-1.25; = 0.77) and major thromboembolic events (OR= 1.14; 95% CI= 0.73-1.77; = 0.58).
Treatment with tranexamic acid could reduce hematoma expansion in intracerebral hemorrhage, and the treatment was safe with no increase in thromboembolic complications. But showed no notable impact on good functional outcomes and mortality.
采用循证医学方法评估氨甲环酸治疗脑出血患者的疗效及安全性。
检索2001年1月至2020年10月期间的Pubmed（MEDLINE）、Embase和Cochrane图书馆，查找随机对照试验（RCT）、队列研究和回顾性病例系列。采用Jadad量表和RevMan 5.3软件进行文献质量评估和荟萃分析。
荟萃分析共纳入4项随机对照试验和1项回顾性病例系列，涉及2808名参与者。与脑出血的对照干预相比，氨甲环酸可显著减少血肿扩大（优势比（OR）=0.81；95%置信区间（CI）=0.68至0.99；P=0.04）以及90天时改良Rankin量表评分（MRS）在0-3分（OR = 1.20；95% CI = 1.00至1.43；P=0.05）、90天时的死亡率（OR= 1.03；95% CI= 0.85-1.25；P=0.77）和主要血栓栓塞事件（OR= 1.14；95% CI= 0.73-1.77；P=0.58）。
氨甲环酸治疗可减少脑出血中的血肿扩大，且该治疗安全，不会增加血栓栓塞并发症。但对良好功能结局和死亡率无显著影响。
