目的 探讨早期强化控制血压对脑出血患者预后的影响.方法 检索Pubmed、Embase和Web of Science数据库2017年9月1之前的文献,纳入比较早期强化控制血压与标准控制血压对脑出血患者预后影响的随机对照研究,进行Meta分析.明确早期强化控制血压对脑出血患者预后的影响.结果 共6项随机对照研究,4376例患者纳入分析.两组病死率分别为10.8%(235/2177)及10.8%(238/2199),严重残疾发生率分别为38.1%(801/2103)和39.9%(848/2123).与标准控制血压相比,早期强化控制血压并未降低脑出血患者病死率(RR=1.00,95%CI:0.84~1.18,P=0.98;I2=0%)及严重残疾发生率(RR=0.95,95%CI:0.88~1.03,P=0.23;I2=0%).结论 早期强化控制血压不能显著改善脑出血患者预后.%Objective To determine the effect of early intensive blood pressure reduction on outcome in patients with cerebral hemorrhage.Methods Pubmed,Embase and Web of Science databases were searched to identify relevant randomized controlled trials(RCT)published before Sep 1st 2017.Meta analyzed the effect of early intensive blood pressure control and standard blood pressure control on outcome of patients with cerebral haemorrhage.Results Six RCTs include 4376 patients were included in analysis.The mortality in intensive and standard were 10.8%(235/2177)and 10.8%(238/2199), respectively; while the incidence of major disability was 38.1%(801/2103)and 39.9%(848/2123), respectively.Compare with standard blood pressure control, intensive blood pressure reduction did not reduce the mortality(RR=1.00,95%CI:0.84 -1.18,P=0.98;I2=0%)and the major disability incidence(RR=0.95,95%CI:0.88 -1.03,P=0.23;I2=0%)in patients with cerebral hemorrhage.Conclusion Early intensive blood pressure reduction can not significantly improve the outcome of cerebral hemorrhage patients.
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