血浆凝血酶-抗凝血酶复合物对缺血性脑卒中的影响：系统评价和荟萃分析。
Effect of plasma thrombin-antithrombin complex on ischemic stroke: a systematic review and meta-analysis.
机构信息
Laboratory Medicine Center, Lanzhou University Second Hospital, Lanzhou, 730000, China.
Department of Anesthesiology, Lanzhou University Second Hospital, Lanzhou, 730000, China.
出版信息
Syst Rev. 2023 Feb 14;12(1):17. doi: 10.1186/s13643-023-02174-9.
BACKGROUND AND OBJECTIVE
Thrombin-antithrombin complex (TAT) is a prethrombotic marker, and its application in ischemic stroke is still uncertain. The purpose of this systematic review and meta-analysis is to evaluate the relationship between plasma TAT and ischemic stroke base on the current evidence.
METHODS
A systematic literature search was conducted for searching the relative studies that investigated the association of TAT and ischemic stroke in PubMed, EMBASE, and Cochrane library databases. Mean difference and 95% confidence interval as the effect sizes were synthesized by random effects model in Review Manager (RevMan) Version 5.4. The heterogeneity was investigated using the chi-square test and the possible sources of heterogeneity were explored by sensitivity analysis and meta-regression. The publication bias was estimated by Egger's tests.
RESULTS
A total of 12 eligible studies were included involving 1431 stroke cases and 532 healthy controls, of which six studies were eventually included in the meta-analysis. Plasma TAT in patients with ischemic stroke was significantly higher than that in healthy controls (MD 5.31, 95% CI = 4.12-6.51, P < 0.0001, I = 97.8%). There is a difference of TAT level in the same period among cardioembolic, lacunar, and atherothrombotic stroke (all P < 0.0001), in which the cardioembolic stroke with the highest level. Meanwhile, it is significant of TAT levels among various phases of cardioembolic stroke and the acute phase are markedly elevated (MD 7.75, 95CI%, 6.07-9.43, P < 0.001). However, no difference was found in the atherothrombotic (P = 0.13) and lacunar stroke (P = 0.34). Besides, the higher TAT level is closely related to the poor prognosis of patients with ischemic stroke, including higher recurrence, mortality, unfavorable recovery (modified Rankin scale > 2), and poor revascularization.
CONCLUSIONS
This study suggested that plasma TAT levels are different in ischemic stroke subtypes, which are closely associated with the progression and might have an effect on the prognosis.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO CRD: 42021248787.
背景与目的
凝血酶-抗凝血酶复合物（TAT）是一种血栓前标志物，其在缺血性卒中中的应用尚不确定。本系统评价和荟萃分析的目的是基于现有证据评估血浆 TAT 与缺血性卒中之间的关系。
方法
我们在 PubMed、EMBASE 和 Cochrane 图书馆数据库中进行了系统文献检索，以查找研究 TAT 与缺血性卒中相关性的相关研究。使用 Review Manager（RevMan）版本 5.4 中的随机效应模型合成均数差和 95%置信区间作为效应量。使用卡方检验评估异质性，并通过敏感性分析和 meta 回归探索异质性的可能来源。使用 Egger 检验估计发表偏倚。
结果
共纳入 12 项符合条件的研究，涉及 1431 例卒中病例和 532 例健康对照者，其中 6 项研究最终纳入荟萃分析。缺血性卒中患者的血浆 TAT 明显高于健康对照组（MD 5.31，95%CI = 4.12-6.51，P < 0.0001，I = 97.8%）。心源性栓塞、腔隙性和动脉粥样硬化血栓性卒中的同期 TAT 水平存在差异（均 P < 0.0001），其中心源性栓塞性卒中的水平最高。同时，心源性栓塞性卒中不同阶段和急性期的 TAT 水平显著升高（MD 7.75，95%CI%，6.07-9.43，P < 0.001）。然而，在动脉粥样硬化血栓性（P = 0.13）和腔隙性卒中（P = 0.34）中未发现差异。此外，较高的 TAT 水平与缺血性卒中患者的不良预后密切相关，包括更高的复发率、死亡率、不利恢复（改良 Rankin 量表>2）和血管再通不良。
结论
本研究表明，血浆 TAT 水平在缺血性卒中亚型中存在差异，与进展密切相关，可能对预后有影响。
系统评价注册
PROSPERO CRD：42021248787。
Zotero 插件