免疫疗法治疗脑卒中的网状Meta分析OACSTPCD

Objective To investigate the clinical efficacy of immunotherapy in stroke.Methods CNKI,VIP,Wanfang Data,CBM,the Cochrane Library,Embase,PubMed,and Web of Science databases were searched for random-ized controlled trials on immunotherapy for stroke published from 2000 to 2022,and RevMan5.3 and Stata14 were used for quality assessment and network meta-analysis.Results A total of 11 articles with 2 742 patients were included.The meta-analysis showed that compared with the placebo control group,the immune drug intervention group had no significant influence on modified Rankin Scale(mRS)score(P=0.45)and Barthel index(P=0.33)on day 90.The network meta-analysis showed that compared with the placebo group,there was a tendency of increase in the proportion of patients with an mRS score of 0-1 in the groups of GSK249320(OR=1.33,95%CI 0.48‒3.67,P>0.05),Abciximab(OR=1.20,95%CI 0.69‒2.07,P>0.05),and Cyclosporine(OR=1.07,95%CI 0.39‒2.95,P>0.05),and there was a tendency of increase in Barthel index in the groups of IL-1Ra(OR=1.22,95%CI 0.75‒1.96,P>0.05)and Abciximab(OR=2.75,95%CI 0.36‒20.96,P>0.05).The largest surface under the cumulative ranking curve(SUCRA)of mRS score was ob-served for GSK249320,followed by Abciximab,Cyclosporine,Placebo,IL-1Ra,Natalizumab,and Enlimomab,and the largest SUCRA of Barthel index was observed for IL-1Ra,followed by Abciximab,Placebo,and Natalizumab.Conclusion Compared with placebo,immunotherapy does not show a better efficacy in the treatment of stroke,which may be associated with the inadequate understanding of the spatiotemporal dynamics and individualized characteristics of stroke immunity and a lack of systematic and comprehensive immunotherapy regimens.