Meta-analysis Of Methylprednisolone For The Treatment Effect And Safety Of Acute Spinal Cord Injury

Objective:Systematic evaluation of the efficacy and safety of high-dose methylprednisolone shock therapy for acute spinal cord injury..Methods:Read the literature and determine the search term.The key words for Chinese search are: "Prednisolone;Acute spinal cord injury;Meta-analysis" and so on.Keyword search in English: "Methylprednisolone;Acute spinal cord injury;Metaanalysis".When retrieving documents,the computer software is used to strictly search the documents.The Chinese search database includes: China Knowledge Network(CNKI)resource database,China Biomedical Literature Service System(Sino Med)and Wanfang Data Knowledge Service Platform.Foreign language search databases include: Pub Med database,Elsevier Science Direct and EBSCO search platform.A randomized controlled trial(RCT)of high-dose shock therapy of methylprednisolone in patients with acute spinal cord injury was collected.Import all the retrieved documents into Note Express document management software,and then filter the documents again after removing the duplicate documents.In the searching process,if there are differences in the inclusion or exclusion criteria of the documents,the third-party researcher will decide.Prioritize the extraction of the required data for documents that meet the inclusion criteria,and after evaluating the risk of bias in the included learning,besides,The Rev Man 5.2 software was used for meta-analysis.Results:In all,13 RCTs were included,And the number is 945 patients,including 503 patients in the MP group and 442 patients in the non-MP group.Meta-analysis results showed: ASIA sensory function score [SMD=19.51,95%CI(15.98,23.03),P<0.00001],ASIA motor function score [SMD=1.22,95%CI(0.89,1.55),P<0.00001],neurological improvement [OR=3.04,95%CI(1.85,4.98),P<0.0001],lung infection ratio [OR=4.33,95%CI(2.55,7.35),P<0.00001],the proportion of gastrointestinal bleeding [OR=2.84,95%CI(1.19,6.76),P=0.02] are superior to the control group,further comparative analysis shows methylprednisolone treatment Improvement of Frankel injury grade in group [OR=4.72,95%CI(2.65,8.40),P<0.00001] was significantly better than the control group,but the urinary infection rate in both groups [OR=1.43,95%CI(0.87,2.34),P=0.16],wound healing rate [RR=1.42,95%CI(0.51,3.94),P=0.50],gastrointestinal reactions [OR=1.45,95%CI(0.73,2.88),P=0.28] no significant statistical difference.Conclusion:When patients with acute spinal cord injury are given methylprednisolone impact therapy,their sensory and motor functions can promote the recovery of the injury.However,drug-related side effects can happen,including gastrointestinal bleeding and lung Infection and so on..