The Efficacy And Safety Of Intravenous Thrombolysis In Acute Ischemic Stroke:A Meta-Analysis

Objective:A direct and Indirect Meta-analysis was performed to compare the efficacay and satety of recombinant tissue-type plasminogen activator and urokinase in acute ischemic stroke patients on the data from the placebo-controlled randomized trials.Methods:Databases were searched from CNKI,the Cochrane Library database, Pubmed, Wanfang database.Collected the rt-PA or urokinase intravenous Thrombolysis for acute ischemic stroke of randomized placebo-controlled trials. The retrieval time is to February 29,2016. The primary safety outcomes were all-cause mortality and symptomatic intracranial hemorrhage. The primary efficacy outcome was the follow-up final favorable neurological assessment (mRS:0-1 or OHS:0-1). The Revman5.3 software was used for direct comparisons, and the ITC (indirect treatment comparisons) software was used for indirect comparisons.Results:Six trials(five trials evaluated rt-PA, one trial evaluated urokinase) were included in the analysis, enrolling 6288 patients. Direct Meta-analysis showed that rt-PA and urokinase significantly increase the rate of favorable neurological score comparing to placebo at the end of follow-up, while there were no significant differences in all-cause mortality at the end of follow-up. Indirect Meta-analysis did not reveal a significant difference among rt-PA and urokinase in favorable neurological score, all-cause mortality, symptoms intracranial hemorrhage.Conclusion:There’s on difference between urokinase and recombinant tissue-type plasminogen activator intravenous thrombolysis for acute ischemic stroke within 6h on efficacy and safety.