| Objective: To evaluate the effect of antihypertensive treatment for ischemic stroke in the acute phase by Meta analysis. In order to provide evidence for the antihypertensive treatment of acute ischemic stroke on the recovery of neural function and clinical curative effect.Methods: Using the Review Manager software 5.2 do meta-analysis for the extracted datas which from the collected 17 case control studies. Using odds ratio(OR) or weighted mean difference(WMD) for effect indicators and test for heterogeneity, select the fixed effects model or random effects model combined OR/WMD and 95% CI. Performed a subgroup analysis of the data and the cumulative analysis, sensitivity analysis, and assessment of publication bias. Search the database such as CNKI, VIP, Wan Fang, Pub Med and Cochrane Library. Blinded evaluation of the quality of the literature according to the literature of design methodology, the allocation scheme. Two authors independently extracted data, and take the quality of evaluations, there are differences to be resolved through consultation. Contact the author write when necessary, and manually search for related conference papers.Results: This article were included in 17 studies, including 16 in Chinese, 1 in English, a cumulative total of cases1754, the intervention group patients(n=880), and the control group(n = 874). The meta-analysis showed: 1. Antihypertensive treatment or not for ischemic stroke in the acute phase:① Compares within the clinical effect: OR 1.72,95%CI(0.56,5.25),Z=0.96,P=0.34>0.05, Antihypertensive treatment group curative effect is not better than the control group.②1 week, 2 weeks, 4 weeks of NIHSS score comparison:WMD-2.13、-1.21、2.10,95%CI(-2.70,-1.55)、(-2.18,-0.24)、(0.81,3.38),Patients with blood pressure treatment can reduce 1 week, 2 weeks and 4 weeks of NIHSS, The recent prognosis is good.③The comparison of the forward NIHSS score: WMD 1.30,95%CI(-1.27,3.86), There was so little difference between The treatment group and control group. 2.Reasonable and effective blood pressure treatment compared with immediate treatment,clinical efficacy OR: 3.28, 95%CI:(1.96,5.48).Conclusion:1. Ischemic stroke in acute phase of blood pressure treatment compared with do not fall blood pressure treatment, can reduce the patients 1 week, 2 weeks and 4 weeks of NIHSS Scores, recent prognosis of patients with relatively good. The forward NIHSS score improvement is not obvious, but patients prognosis is poorer.2. Antihypertensive treatment or not for ischemic stroke in the acute phase the curative effect is not difference. According to the patients’ blood pressure levels, reasonable and effective blood pressure treatment compared with immediate treatment, the clinical efficacy is relatively well to the prognosis of the patients. |
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