Cheng Xiaofang, Ren Qiuxia, Zhi Jianxia, Chen Quanhui, Luo Kaifa, Yu Liheng, Jiao Shusheng
Department of Neurology, Bethune International Peace Hospital, Shijiazhuang, Hebei, China.
Department of Gastroenterology, Bethune International Peace Hospital, Shijiazhuang, Hebei, China.
Medicine (Baltimore). 2024 Dec 13;103(50):e40668. doi: 10.1097/MD.0000000000040668.
Cilostazol is an antiplatelet drug and is used for stroke prevention and symptomatic peripheral vascular disease. Studies have reported the effects of cilostazol on cognitive function, but the results are inconsistent and have not been systematically assessed.
We systematically searched the PubMed, Embase, and Cochrane databases for relevant clinical studies. The primary outcome was the change in Mini-mental State Examination (MMSE) scores from baseline to the last available follow-up. The secondary outcome was dementia risk. Mean differences and 95% confidence intervals (CIs) were calculated for combining MMSE scores, and the pooled odds ratios and 95% CIs were used to calculate the association between use of cilostazol and dementia risk.
Overall, 8 eligible studies met inclusion criteria were pooled in meta-analysis. Though with a trend toward favoring cilostazol, the pooled changes in MMSE scores from baseline showed no significant difference in mild cognitive impairment and dementia patients (mean differences 1.02, 95% CI -0.53 to 2.57, P = .195). For secondary outcome, cilostazol reduced the risk of dementia in patients without prior history of dementia (pooled odds ratios 0.90; 95% CI 0.87 to 0.92; P = .000).
These results suggest the potential for cilostazol treatment in the suppression of cognitive decline and prevention of progression to dementia. However, the lack of blinding in most studies is likely to cause an overestimation of the effect sizes, and further well-designed studies are also needed.
西洛他唑是一种抗血小板药物，用于预防中风和治疗有症状的外周血管疾病。已有研究报道了西洛他唑对认知功能的影响，但结果并不一致，且尚未进行系统评估。
我们系统检索了PubMed、Embase和Cochrane数据库中的相关临床研究。主要结局是简易精神状态检查表（MMSE）得分从基线到最后一次可用随访的变化。次要结局是痴呆风险。计算合并MMSE得分的平均差异和95%置信区间（CI），并使用合并比值比和95%CI计算西洛他唑使用与痴呆风险之间的关联。
总体而言，8项符合纳入标准的合格研究被纳入荟萃分析。尽管有支持西洛他唑的趋势，但在轻度认知障碍和痴呆患者中，MMSE得分从基线的合并变化无显著差异（平均差异1.02，95%CI -0.53至2.57，P = 0.195）。对于次要结局，西洛他唑降低了无痴呆病史患者的痴呆风险（合并比值比0.90；95%CI 0.87至0.92；P = 0.000）。
这些结果表明西洛他唑治疗在抑制认知衰退和预防进展为痴呆方面具有潜力。然而，大多数研究缺乏盲法可能导致效应量被高估，还需要进一步设计良好的研究。
