未经授权:在过去的几十年里,创伤性脑损伤(TBI)病理学研究的进展动态地丰富了我们的知识。因此,我们旨在系统阐明促红细胞生成素(EPO)给药方案在TBI患者中的安全性和有效性.
UNASSIGNED:数据搜索包括PubMed,Cochrane图书馆,Embase,WebofScience,和ClinicalTrials.gov在2022年7月之前发表的相关研究。使用ADDIS1.16.8进行网络荟萃分析,并使用CINeMA工具评估证据的质量水平。
UNASSIGNED:共6个RCT,981名患者纳入网络meta分析。EPO并未显著降低TBI患者的死亡率,但其死亡风险随着剂量的增加而降低(优势比(OR)为12,000u与安慰剂=0.98,95%CI:0.03-40.34;30,000u组的OR与安慰剂=0.56,95%CI:0.06-5.88;OR为40,000uvs.安慰剂=0.35,95%CI:0.01-9.43;OR为70,000uvs.安慰剂=0.29,95%CI:0.01-9.26;80,000u组的OR与安慰剂=0.22,95%CI:0.00-7.45)。共有3项涉及739例患者的研究表明,EPO并未增加TBI患者深静脉血栓形成的发生率。然而,随着剂量的增加,风险趋于上升。另外两项研究表明,EPO不会增加肺栓塞的发生率。所有结果的证据质量为低至中等。
UNASSIGNED:尽管EPO的疗效没有统计学证明,我们发现,在TBI患者中,EPO剂量与死亡率降低和栓塞事件增加之间存在关联的趋势.应进行更多高质量的原始研究,以获得EPO最佳剂量的有力证据。
UNASSIGNED:https://www。crd.约克。AC.uk/PROSPERO/display_record。php?RecordID=272500。研究方案在PROSPERO(CRD42021272500)注册。
UNASSIGNED: Over the past few decades, advances in traumatic brain injury (TBI) pathology research have dynamically enriched our knowledge. Therefore, we aimed to systematically elucidate the safety and efficacy of erythropoietin (EPO) dosing regimens in patients with TBI.
UNASSIGNED: Data search included PubMed, the Cochrane Library, Embase, Web of Science, and ClinicalTrials.gov for related research published before July 2022. The network meta-analysis was conducted using ADDIS 1.16.8, and the CINeMA tool was used to assess the quality level of evidence.
UNASSIGNED: A total of six RCTs involving 981 patients were included in the network meta-analysis. EPO did not significantly reduce mortality in patients with TBI, but its risk of death decreased with increasing dosage (odds ratio (OR) of 12,000u vs. placebo = 0.98, 95% CI: 0.03-40.34; OR of group 30,000u vs. placebo = 0.56, 95% CI: 0.06-5.88; OR of 40,000u vs. placebo = 0.35, 95% CI: 0.01-9.43; OR of 70,000u vs. placebo = 0.29, 95% CI: 0.01-9.26; OR of group 80,000u vs. placebo = 0.22, 95% CI: 0.00-7.45). A total of three studies involving 739 patients showed that EPO did not increase the incidence of deep vein thrombosis in patients with TBI. However, the risk tended to rise as the dosage increased. Another two studies demonstrated that EPO did not increase the incidence of pulmonary embolism. The quality of evidence for all outcomes was low to moderate.
UNASSIGNED: Although the efficacy of EPO was not statistically demonstrated, we found a trend toward an association between EPO dosage and reduced mortality and increased embolic events in patients with TBI. More high-quality original studies should be conducted to obtain strong evidence on the optimal dosage of EPO.
UNASSIGNED: https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=272500. The study protocol was registered with PROSPERO (CRD42021272500).