目的 通過評價3種改善血液循環(huán)類藥物（阿加曲班注射液、丁苯酞注射液和尤瑞克林注射液）分別聯(lián)合基礎(chǔ)治療（抗血小板+調(diào)脂、抗血小板+調(diào)脂+阿替普酶）用于治療急性腦梗死的有效性、安全性及經(jīng)濟性，為相關(guān)決策提供參考。方法 檢索中國知網(wǎng)數(shù)據(jù)庫、重慶維普中文科技期刊數(shù)據(jù)庫、萬方數(shù)據(jù)庫、PubMed、Web of Science等數(shù)據(jù)庫并搜集相關(guān)的臨床試驗，采用Stata 14.1軟件，進行基于NIHSS有效率、不良反應(yīng)發(fā)生率的網(wǎng)狀Meta分析，以評價有效性和安全性；采用最小成本分析法和成本-效果分析法進行經(jīng)濟性評價。結(jié)果 共納入32篇文獻，涉及3 071例患者。有效性和安全性網(wǎng)狀Meta分析結(jié)果均顯示，各干預(yù)措施的差異無統(tǒng)計學意義。但從嚴重不良反應(yīng)發(fā)生情況來看，阿加曲班組的嚴重不良反應(yīng)發(fā)生率相對最低，安全性相對最好，其次依次為丁苯酞組和尤瑞克林組。經(jīng)濟性評價結(jié)果顯示，阿加曲班組的經(jīng)濟性相對最佳。結(jié)論 與丁苯酞組和尤瑞克林組相比，阿加曲班聯(lián)合基礎(chǔ)治療的有效性和安全性良好、嚴重不良反應(yīng)最少，且經(jīng)濟性最佳。

Objective The efficacy, safety and economy of three blood circulation drugs (Argatroban injection, butylphthalide injection and Urinary Kallidinogenase injection) combined with basic treatment (antiplatelet agent+lipid-lowering medication/antiplatelet agent lipid-lowering medication+rt-PA) for acute cerebral infarction were evaluated to provide reference for relevant decision-making. Methods By searching CNKI, VIP, Wangfang databases, and PubMed, Web of Science databases, and collecting relevant clinical trials, Stata 14.1 software was used to evaluate the efficacy and safety of network Meta analysis based on NIHSS effectiveness rate and adverse reaction incidence. Minimum cost analysis method and cost-effect analysis method are used to evaluate economy. Results A total of 32 articles were included, involving 3 071 patients. The results of efficacy and safety mesh meta-analysis showed that there were no statistically significant differences between the interventions. However, in terms of the occurrence of severe adverse reactions, the argatroban group had a lower incidence of severe adverse reactions and a relatively better safety, followed by the butylphthalide group and the Urinary Kallidinogenase group. The economic evaluation results show that the economic performance of argatroban group is the best. Conclusion Compared with butylphthalide and urinary kallidinogenase group, argatroban combined with basic therapy has good efficacy and safety, the least serious adverse reactions, and the best economy.

R971