| Background Cerebrovascular disease is one of the three deadly diseases in most regions of the world,with the other two being ischemic heart disease and malignant tumor.Stroke is the major clinical type of it.Transient Ischemic Attack(TIA)is a common acute cerebrovascular disease,and the first week is high-risk period of its onset that progress to ischemic stroke.So the intervention treatment for patients of TIA in the early stage can reduce the risk of evolving to ischemic stroke.Urinary kallikrein's main component is a kind of tissue-type proteolytic enzyme which extracts from the urine of human.It usually applied in the treatment of acute cerebral infarction at the initial stage,and it also applied in the control of the onset of TIA in the early stage of our country in recent years.As a new drug for the treatment of TIA,there were more and more domestic corresponding clinical studies of human urinary kallidinogenase injection for TIA,and some certain therapeutic effect were achieved.Objective To systematically evaluate the efficacy of urinary kallikrein in the treatment of TIA through making a meta-analysis with corresponding studies.Methods Establishing the searching strategy,the inclusion criteria and the exclusion criteria according to the principle of PICOS and screening the clinical randomized controlled trials(RCT).The relevant literatures about the efficacy of urinary kallikrein in the treatment of TIA were collected through retrieving the electronic literature databases such as the foreign databases including Pun Med,the Cochrane Library and the Chinese database including China National Knowledge Internet(CNKI),Chinese Science and Technology Periodical Database(VIP),Wanfang Data Knowledge Service Platform and so on when published till January,2017.The methodological quality of the included trials were evaluated by using the bias' risk assessment tool of the handbook from the Cochrane Collaboration.And the efficacy of urinary kallikrein in the treatment of TIA were investigated and the odds ratio(OR)values and its 95% confidence interval(CI)were calculated through meta-analyed the selected literatures by Rev Man5.3 from the CochraneCollaboration.Results Of 34 potentially relevant ciations researched,8 literatures which met the criteria were included in this meta-analysis through selection.These studies included 721 clinically diagnosed TIA patients,in the experimental group(add with urinary kallikrein),a total of 359 cases,in the control group(routine therapy),a total of 362 cases.The meta-analysis of effectiveness between the experimental group and the control group revealed that heterogeneity inspection result showed Q=4.22,P=0.75,I2=0%,that the effect between volume had the homogeneity,and the fixed effects model was adopted.And the result showed OR=5.59,95%CI[3.45,9.06],Z=7.00,P<0.05,that the total effective rate of the experimental group was higher than that of the control group,and the differences were statistically significant.The meta-analysis of adverse reactions between the experimental group and the control group revealed that heterogeneity inspection result showed Q=8.88,P=0.06,I2=55%,that the effect between volume had the moderate heterogeneity,and the random effects model was adopted.And the result showed OR=1.19,95%CI[0.18,7.88],Z=0.18,P>0.05,that the side effect differences were no statistically significant.It meant that add urinary kallikrein in the rountine treatment for the patients of TIA would not increase the obvious side effects.Conclusion According to the consequence of this meta-analysis,the curative effect of urinary kallikrein in the treatment for patients of TIA is better,and there is no significant difference that compare with other common basic therapys in the security.But because of the relevant trials is not enough,it may has the risk of the corresponding bias.So it still need more high quality clinical randomized controlled trials to testify the efficacy of urinary kallikrein for TIA. |
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