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Efficacy and Safety Recombinant Activated FactorⅦin Acute Intracerebral Hemorrhage Patients without Hemophilia:a Meta-Analysis

Efficacy and Safety Recombinant Activated FactorⅦin Acute I...

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浙江省医学会创伤学分会成立大会暨2009年浙江省创伤学术年会

作者： Huang WD,Yuan ZH,Jiang JK,Pan J,Zhu JY,Wang JZ. Department of Emergency,the First Affiliated Hospital,College of Medicine, Zhejiang University,Hangzhou,China(310003)

Background:Hematoma growth is common in intracerebral hemorrhage(ICH) and is associated with the poor *** results were inconsistent in the trials that used recombinant activated factorⅦ(rFⅦa) to treat patients with ***:To evaluate the efficacy and safety of rFⅦa used as hemostatic agent in patients with ***:Medline,Scopus,the Cochrane Library,*** and Stroke Trials Directory were searched for placebo controlled trials of rFⅦa in patients without *** for dichotomous outcomes expressed as odds ratio(OR) with 95%confidence intervals(CI) and continuous outcomes as weighted mean difference(WMD).Fixed-effect model or random-effects model was used according to whether or not *** analyses were performed according to total dose of rFⅦa ***:Five randomized controlled trials - four spontaneous ICH(sICH) and one traumatic ICH(tICH) - were selected for *** the total 1402 subjects studied in the 5 trials,989patients(61 with tICH) received rFⅦa,413(36 with tICH) received *** rFⅦa can reduce the change of ICH volume,there was no significant difference in mortality(OR=0.86,95%CI[0.65,1.15]),scale of modified Rankin Scale(MRS)(grades 4 to 6)(OR=0.89,95%CI[0.48,1.39]) or extended Glasgow Outcome Scale(GOS-E)(grades 1 to 4)(OR= 0.91,95%CI[0.30,2.71]) between rFⅦa and *** was a significant increase of arterial thromboembolic adverse events (TAE) in rFⅦa group(OR=2.18,95%CI[1.13,4.19]).Besides the increase of incidence of DVT in tICH(OR=3.13,95%CI[0.35, 27.87]),similar results were observed in sICH and ***:Use of rFⅦa reduces the growth of the hematoma but does not improve survival or functional outcome after ICH;in addition,it increases the incidence of arterial *** any future study to confirm the clinical benefit of rFⅦa in ICH,thromboembolic risk should be carefully monitored.

关键词： intracerebral hemorrhage Recombinant Activated FactorⅦ randomized controlled trial meta-analysis thromboembolic adverse events

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