Department of Neurology, Nanjing Lishui People's Hospital, Zhongda Hospital Lishui Branch, Southeast University, Nanjing, Jiangshu 211200, China.
Department of Neurology, Nanjing Lishui People's Hospital, Zhongda Hospital Lishui Branch, Southeast University, Nanjing, Jiangshu 211200, China.
Clinics (Sao Paulo). 2023 Jun 1;78:100218. doi: 10.1016/j.clinsp.2023.100218. eCollection 2023.
Stroke is a major global public health problem, affecting 13.7 million people worldwide. Previous studies have found a neuroprotective effect of hypothermia therapy and the efficacy and safety of combined hypothermia and mechanical thrombectomy or thrombolysis in the treatment of ischemic stroke have also attracted attention.
In the present research, the authors conducted a meta-analysis to comprehensively assess the safety and efficacy of hypothermia combining mechanical thrombectomy or thrombolysis in the treatment of ischemic stroke.
Articles published from January 2001 to May 2022 were searched from Google Scholar, Baidu Scholar and PubMed to evaluate the clinical significance of hypothermia treatment in ischemic stroke. Complications, short-term mortality, and the modified Rankin Scale (mRS) in the full text was extracted.
89 publications were selected and 9 among them were included in this study with sample size of 643. All selected studies are in accordance with the inclusion criteria. Forest plot of clinical characteristics was as follows: complications (RR = 1.132, 95% CI 0.942‒1.361, p = 0.186, I = 37.2%), mortality within 3 months (RR = 1.076, 95% CI 0.694‒1.669, p = 0.744, I = 0.00%), mRS ≤ 1 at 3 months (RR = 1.138, 95% CI 0.829‒1.563, p = 0.423, I = 26.0%), mRS ≤ 2 at 3 months (RR = 1.672, 95% CI 1.236‒2.263, p = 0.001, I=49.6%) and mRS ≤ 3 at 3 months (RR = 1.518, 95% CI 1.128‒2.043, p = 0.006, I = 0.00%). The funnel plot suggested that there was no significant publication bias in the meta-analysis on complications, mortality within 3 months, mRS ≤ 1 at 3 months and mRS ≤ 2 at 3 months.
In summary, the results showed that hypothermia treatment was correlated with mRS ≤ 2 at 3 months, but not linked with complications and mortality within 3 months.
中风是一个全球性的重大公共卫生问题,影响全球 1370 万人。既往研究发现低温治疗具有神经保护作用,且低温联合机械取栓或溶栓治疗缺血性卒中的疗效和安全性也受到关注。
本研究作者进行了一项荟萃分析,以全面评估低温联合机械取栓或溶栓治疗缺血性卒中的安全性和有效性。
从 Google Scholar、百度学术和 PubMed 中检索 2001 年 1 月至 2022 年 5 月发表的文章,以评估低温治疗缺血性卒中的临床意义。提取全文中的并发症、短期死亡率和改良 Rankin 量表(mRS)。
共纳入 89 篇文献,其中 9 篇符合纳入标准。共纳入 643 例患者。所有纳入研究均符合纳入标准。临床特征的森林图如下:并发症(RR=1.132,95%CI 0.942‒1.361,p=0.186,I=37.2%)、3 个月内死亡率(RR=1.076,95%CI 0.694‒1.669,p=0.744,I=0.00%)、3 个月 mRS≤1(RR=1.138,95%CI 0.829‒1.563,p=0.423,I=26.0%)、3 个月 mRS≤2(RR=1.672,95%CI 1.236‒2.263,p=0.001,I=49.6%)和 3 个月 mRS≤3(RR=1.518,95%CI 1.128‒2.043,p=0.006,I=0.00%)。漏斗图提示,在并发症、3 个月内死亡率、3 个月 mRS≤1 和 3 个月 mRS≤2 的荟萃分析中,没有明显的发表偏倚。
总之,结果表明低温治疗与 3 个月时 mRS≤2 相关,但与 3 个月内并发症和死亡率无关。