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机械取栓治疗伴有大血管闭塞的轻度急性缺血性脑卒中:系统评价和荟萃分析。

Mechanical Thrombectomy for Mild Acute Ischemic Stroke with Large-Vessel Occlusion: A Systematic Review and Meta-Analysis.

机构信息

School of Public Health, Shenyang Medical College, Shenyang, China.

出版信息

Cerebrovasc Dis. 2022;51(5):615-622. doi: 10.1159/000523838. Epub 2022 Apr 4.

Abstract

BACKGROUND

The functional prognosis of mechanical thrombectomy (MT) for mild acute ischemic stroke (AIS) with large-vessel occlusion (LVO) is controversial. To explore a more precise estimation, a meta-analysis was conducted.

METHODS

The relevant studies were identified by searching PubMed, Embase, Web of Science, and Cochrane Collaboration Database until October 2021. The pooled analysis, subgroup analysis, sensitivity analysis, and publication bias examination were all conducted. The meta-analysis was performed by using Stata 12.0.

RESULTS

Eleven studies were included with a total of 1,929 subjects, including 794 patients receiving MT and 1,135 patients receiving medical management. The pooled analysis showed that MT might be not associated with functional prognosis among mild AIS with LVO (excellent functional prognosis: risk ratio (RR) = 1.07, 95% confidence interval (CI) = 0.94-1.21, p = 0.294; favorable functional prognosis: RR = 1.01, 95% CI = 0.96-1.06, p = 0.823). The statistical stability and reliability were demonstrated by the sensitivity analysis and publication bias outcomes.

CONCLUSION

Our meta-analysis suggests that MT may be not associated with functional prognosis of mild AIS with LVO.

摘要

背景

机械取栓(MT)治疗伴有大血管闭塞(LVO)的轻度急性缺血性卒中(AIS)的功能预后仍存在争议。为了更精确地评估这一问题,我们进行了一项荟萃分析。

方法

通过检索 PubMed、Embase、Web of Science 和 Cochrane 协作数据库,我们于 2021 年 10 月前收集了相关研究。进行了汇总分析、亚组分析、敏感性分析和发表偏倚检验。使用 Stata 12.0 进行荟萃分析。

结果

共纳入 11 项研究,总计 1929 例患者,其中 794 例患者接受 MT 治疗,1135 例患者接受药物治疗。汇总分析显示,MT 治疗对伴有 LVO 的轻度 AIS 的功能预后可能无影响(优秀的功能预后:风险比(RR)=1.07,95%置信区间(CI)=0.94-1.21,p=0.294;有利的功能预后:RR=1.01,95%CI=0.96-1.06,p=0.823)。敏感性分析和发表偏倚结果表明,该结果具有统计稳定性和可靠性。

结论

本荟萃分析表明,MT 治疗可能与伴有 LVO 的轻度 AIS 的功能预后无相关性。

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