選擇性5-羥色胺再攝取抑制劑治療腦卒中對功能獨立影響的Meta分析

黃超平 陳素芬 胡玨

[摘要] 目的 系統(tǒng)評價在腦卒中早期（發(fā)病15 d內(nèi)）使用選擇性5-羥色胺再攝取抑制劑（SSRIs）治療對功能獨立的安全性和有效性。 方法 計算機檢索中國知網(wǎng)全文數(shù)據(jù)庫、萬方數(shù)據(jù)庫、維普中文數(shù)據(jù)庫、PubMed、Embase、The Cochrane Library數(shù)據(jù)庫，搜索關(guān)于SSRIs與安慰劑對比治療腦卒中的隨機對照試驗（RCT），檢索時限均從建庫至2020年8月31日。采用 RevMan 5.3 軟件與Stata16進(jìn)行Meta 分析。 結(jié)果 共納入5項RCT，包括5462例患者。Meta分析結(jié)果顯示，與對照組相比，早期使用SSRIs不能改善腦卒中患者的功能獨立[OR=1.44，95%CI（0.89～2.34），P=0.14];可顯著降低卒中后抑郁的發(fā)病率[OR=0.69，95%CI（0.59～0.81），P<0.000 01];但增加骨折的風(fēng)險[OR=2.19，95%CI（1.44～3.32），P=0.0002];兩組在死亡、卒中復(fù)發(fā)、癲癇等方面比較，差異無統(tǒng)計學(xué)意義（P>0.05）。結(jié)論 早期使用SSRIs治療不能顯著改善腦卒中患者的功能獨立，不支持作為腦卒中的常規(guī)治療策略。

[關(guān)鍵詞] 選擇性5-羥色胺再攝取抑制劑;腦卒中;Meta分析;功能獨立;隨機對照試驗

[中圖分類號] R794.4? ? ? ? ? [文獻(xiàn)標(biāo)識碼] A? ? ? ? ? [文章編號] 1673-9701（2021）24-0018-06

Meta-analysis of effect of selective serotonin reuptake inhibitors on function independence in treatment of stroke

HUANG Chaoping1? ?CHEN Sufen2? ?HU Jue2

1.Hunan University of Chinese Medicine， Changsha? ?410208，China; 2.Department of Neurology， Changsha Central Hospital， Changsha? ?410000，China

[Abstract] Objective To systematically evaluate the safety and effectiveness of selective serotonin reuptake inhibitors （SSRIs） for functional independence in the treatment of early stage of stroke （within 15 days of onset）. Methods The CNKI full-text database， Wanfang database， VIP Chinese database， PubMed， Embase， and Cochrane Library database were searched for randomized controlled trials （RCTs） on SSRIs versus placebo in the treatment of stroke. The date searched was limited as from the establishment of the database to August 31， 2020. Meta-analysis was performed using RevMan 5.3 software and Stata16. Results A total of 5 RCTs were included， including 5462 patients. Meta-analysis results showed that compared with the control group， early use of SSRIs could not improve the function independence in stroke patients [OR=1.44， 95%CI （0.89-2.34）， P=0.14]. It significantly reduced the incidence of post-stroke depression [OR=0.69， 95%CI （0.59-0.81）， P<0.000 01]， but increased the risk of fracture [OR=2.19， 95%CI （1.44-3.32）， P=0.0002]. There were no statistically significant differences in death， stroke recurrence and epilepsy between the two groups. Conclusion The current research evidence shows that early treatment with SSRIs cannot significantly improve the function independence in stroke patients and does not support the use of SSRIs as a conventional treatment strategy for stroke.

[Key words] Selective serotonin reuptake inhibitors; Stroke; Meta-analysis; Function independence; Randomized controlled trials