| Objective:System evaluation of curative effect and security for recombinant tis sue-type plasminogen activator (rt-PA) in treatment of acute ischemic stroke. Meth ods:Retrieve the Cochrane library (The3rd issue in2013), PUBMED, EMbase dat abase, Chinese biomedical literature database, China academic journal full-text datab ase, collect the rt-PA or placebo treatment for acute ischemic stroke of randomized or non randomized controlled trial, the retrieval time for January1995-June2013. According to include and exclude the selection standard, two evaluators extract inf ormation and evaluate the quality and use RevMan5.0software for Meta analysis. Resurts:Incorporated into seven randomized controlled trial(RCT), there are a tot al of6548cases of patients. Meta analysis showed:favorable neurological score of rt-PA in patients with acute ischemic stroke between3and6month[RR=1.22,95%CI(1.10,1.35), P=0.0002] are higher than that of the placebo group; rt-PA in t reatment of patients within0-3h time window[RR=1.53,95%CI(1.32,1.78), P<0.0001],3-4.5h [RR=1.13,95%CI(1.02,1.25), P=0.02] better than that of the place bo group, with no difference between4.5-6h and the placebo group. symptomatic i ntracranial hemorrhage rate in rt-PA treated group [RR=3.94,95%CI(2.31,6.70), P <0.00001] are higher than that of the placebo group, but there is no statistical diff erence in overall mortality of the two groups between3and6month. Conclusion: Within0-4.5h time window, compared with placebo group, rt-PA treatment of acu te ischemic stroke can get better favorable neurological score. In4.5-6h time wind ow, there is no difference between two groups. Symptomatic intracranial bleeding r ate after thrombolysis in rt-PA group are higher than the placebo group, with no d ifference in overall mortality of two groups of three to six months. Due to the lim ited number included, this study still needs more high-quality randomized controlled trials to confirm. |
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