Abstract：
This systematic review aims to summarize the findings from all clinical randomized trials assessing the efficacy of potential neuroprotective agents in influencing the outcomes of acute spinal cord injuries (SCI). Following the PRISMA guidelines, we conducted comprehensive searches in four electronic databases (PubMed, Scopus, Cochrane Library, and Web of Science) up to September 5th, 2023. Our analysis included a total of 30 studies. We examined the effects of 15 substances/drugs: methylprednisolone, tirilazad mesylate, erythropoietin, nimodipine, naloxone, Sygen, Rho protein antagonist, granulocyte colony-stimulating factor, autologous macrophages, autologous bone marrow cells, vitamin D, progesterone, riluzole, minocycline, and blood alcohol concentration. Notable improvements in neurological outcomes were observed with progesterone plus vitamin D and granulocyte colony-stimulating factor. In contrast, results for methylprednisolone, erythropoietin, Sygen, Rho Protein, and Riluzole were inconclusive, primarily due to insufficient sample size or outdated evidence. No significant differences were found in the remaining evaluated drugs. Progesterone plus vitamin D, granulocyte colony-stimulating factor, methylprednisolone, Sygen, Rho Protein, and Riluzole may enhance neurological outcomes in acute SCI cases. It is worth noting that different endpoints or additional subgroup analyses may potentially alter the conclusions of individual trials. Therefore, certain SCI grades may benefit more from these treatments than others, while the overall results may remain inconclusive.
摘要：
本系统综述旨在总结所有评估潜在神经保护剂影响急性脊髓损伤（SCI）预后的临床随机试验的结果。按照PRISMA准则，我们在四个电子数据库(PubMed，Scopus,科克伦图书馆,和WebofScience)截至9月5日，2023年。我们的分析共包括30项研究。我们检查了15种物质/药物的作用：甲基强的松龙，甲磺酸替利拉扎德，促红细胞生成素,尼莫地平,纳洛酮,Sygen,Rho蛋白拮抗剂,粒细胞集落刺激因子，自体巨噬细胞，自体骨髓细胞，维生素D,黄体酮,利鲁唑,米诺环素,和血液酒精浓度。黄体酮加维生素D和粒细胞集落刺激因子可显著改善神经系统预后。相比之下,甲基强的松龙的结果，促红细胞生成素,Sygen,Rho蛋白,利鲁唑没有定论，主要是由于样本量不足或证据过时。在其余评估药物中没有发现显著差异。黄体酮加维生素D,粒细胞集落刺激因子，甲基强的松龙,Sygen,Rho蛋白,利鲁唑可增强急性SCI患者的神经系统预后。值得注意的是，不同的终点或额外的亚组分析可能会改变个别试验的结论。因此,某些SCI等级可能会从这些治疗中受益更多，而总体结果可能仍无定论。
