■使用硫酸镁治疗动脉瘤性蛛网膜下腔出血(aSAH)的研究结果不一致。为了评估硫酸镁对aSAH后结局的影响,我们对相关随机对照试验进行了系统评价和荟萃分析.
■PubMed,Embase,从数据库开始到2023年3月20日,在Cochrane图书馆搜索了有关硫酸镁用于aSAH的相关文献。主要结果是脑血管痉挛(CV),次要结局包括迟发性脑缺血(DCI),继发性脑梗死,再出血,神经功能障碍,和死亡率。
■在558项确定的研究中,包括3,503名患者在内的16名患者符合资格并纳入分析。与对照组(生理盐水或标准治疗)相比,据报道,CV[优势比(OR)=0.61,p=0.04,95%置信区间(CI)(0.37-0.99)]的结局存在显着差异,DCI[OR=0.57,p=0.01,95%CI(0.37-0.88)],硫酸镁给药后继发性脑梗死[OR=0.49,p=0.01,95%CI(0.27-0.87)]和神经功能障碍[OR=0.55,p=0.04,95%CI(0.32-0.96)],两组间死亡率[OR=0.92,p=0.47,95%CI(0.73-1.15)]和再出血[OR=0.68,p=0.55,95%CI(0.19-2.40)]无显著差异.
■硫酸镁优于CV标准治疗,DCI,继发性脑梗死,并证实了aSAH患者的神经功能障碍。需要进一步的随机试验以增加样本量来验证这些发现。
UNASSIGNED: The use of magnesium sulfate for treating aneurysmal subarachnoid hemorrhage (aSAH) has shown inconsistent results across studies. To assess the impact of magnesium sulfate on outcomes after aSAH, we conducted a systematic
review and meta-analysis of relevant randomized controlled trials.
UNASSIGNED: PubMed, Embase, and the Cochrane Library were searched for relevant literature on magnesium sulfate for aSAH from database inception to March 20, 2023. The primary outcome was cerebral vasospasm (CV), and secondary outcomes included delayed cerebral ischemia (DCI), secondary cerebral infarction, rebleeding, neurological dysfunction, and mortality.
UNASSIGNED: Of the 558 identified studies, 16 comprising 3,503 patients were eligible and included in the analysis. Compared with control groups (saline or standard treatment), significant differences were reported in outcomes of CV [odds ratio (OR) = 0.61, p = 0.04, 95% confidence interval (CI) (0.37-0.99)], DCI [OR = 0.57, p = 0.01, 95% CI (0.37-0.88)], secondary cerebral infarction [OR = 0.49, p = 0.01, 95% CI (0.27-0.87)] and neurological dysfunction [OR = 0.55, p = 0.04, 95% CI (0.32-0.96)] after magnesium sulfate administration, with no significant differences detected in mortality [OR = 0.92, p = 0.47, 95% CI (0.73-1.15)] and rebleeding [OR = 0.68, p = 0.55, 95% CI (0.19-2.40)] between the two groups.
UNASSIGNED: The superiority of magnesium sulfate over standard treatments for CV, DCI, secondary cerebral infarction, and neurological dysfunction in patients with aSAH was demonstrated. Further randomized trials are warranted to validate these findings with increased sample sizes.