OBJECTIVE: To evaluate the effectiveness and safety of fasudil hydrochloride in the treatment of cerebral vasospasm (CVS) after subarachnoid hemorrhage (SAH). METHODS: Random controlled trails (RCT) on fasudil hydrochloride treatment for CVS after SAH were gathered from CBM, CNKI, Wanfang database, VIP. Other relative researches were searched manually. Methodological quality of included researches was evaluated, and meta-analysis was carried out by RevManS.0 software. RESULTS: A total of 19 RCT were collected. Results of Meta-analysis showed that for the total effective rate and the incidence of cerebral vasospasm, there was no significant differences between fasudil 30 mg, q 8 h and nimodipine 24 mg·d-1. RR and 95％CI were equal to 1.06 (0.98, 1.16) and 1.17 (0.53, 2.59). The differences of the total effective rate between trail group and nimodipine 10 mg·d-1 had statistical significance, and the RR and 95％CI were 1.30 (1.11, 1.52). CONCLUSION: According to the current evidence in China, the treatment of fasudil for CVS after SAH can increase the total effective rate and reduce the incidence of cerebral vasospasm. The difference of effectiveness between fasudil and nimodipine is affected by dose and route of administration.%目的:评价法舒地尔治疗蛛网膜下腔出血后脑血管痉挛的有效性和安全性.方法:计算机检索中国期刊全文数据库(CNKI)、中国生物医学文献数据库(CBM)、万方数字化期刊全文数据库、中文科技期刊全文数据库(VIP),纳入法舒地尔治疗蛛网膜下腔出血后脑血管痉挛的随机对照试验(RCT)文献;手工检索其他相关文献.对纳入研究进行方法学质量评价,并采用RevMan5.0软件进行Meta分析.结果:共纳入19个RCT.Meta分析结果显示,对于总有效率和脑血管痉挛发生率,法舒地尔30mg,q8 h单用与尼莫地平24mg·d-1单用比较差异无统计学意义;总有效率的RR及其95%CI分别为1.06(0.98,1.16),脑血管痉挛发生率的RR及其95%CI分别为1.17(0.53,2.59);法舒地尔30mg,q 8 h单用与尼莫地平10mg·d-1单用比较差异有统计学意义;总有效率的RR及其95%CI分别为1.30(1.11,1.52).结论:目前国内证据表明,应用法舒地尔治疗蛛网膜下腔出血后脑血管痉挛能增加总有效率和减少脑血管痉挛发生率.法舒地尔和尼莫地平的有效性差异受使用剂量和给药途径影响.
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