血管认知障碍的治疗策略:系统性审查和元分析
Federico Masserini1,2, Claudia Gendarini1,3, Giacomo Baso1,3
1Neuroscience Research Center, Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy.
Alzheimer's & dementia : the journal of the Alzheimer's Association
|November 6, 2025
概括
血管认知障碍 (VCI) 治疗显示适度的效果,金刚果比洛巴提取物显示出最多的益处. 未来的研究需要解决试验异质性问题,并专注于特定的VCI亚型,以获得更好的结果.
科学领域:
- 神经学 神经学
- 药理学 药理学是指药理学的学科.
- 临床试验 临床试验
背景情况:
- 血管认知障碍 (VCI) 是一种普遍但异质的神经疾病.
- 目前,对于VCI没有批准的治疗方法,这突显了未满足的医疗需求.
研究的目的:
- 对VCI进行研究的治疗策略进行审查.
- 对符合条件的干预措施的疗效数据进行元分析.
- 评估重新考虑以前测试的VCI治疗的可能性.
主要方法:
- 对VCI的临床试验进行系统审查.
- 来自173项涉及22347名参与者的试验的疗效数据的元分析.
- 在四个VCI类别中提取了91项干预和145个结果的数据.
主要成果:
- 银杏花提取物表现出大到中等的认知改善 (科恩d:0.83) 和小到中等的功能改善 (科恩d:0.50).
- 乙胆酶抑制剂,美曼丁,大脑素,普罗菲林,体育炼和认知康复显示出小到中等的认知益处.
- 在VCI试验中观察到实质性的异质性,影响了证据的强度.
结论:
- 在VCI试验中的方法异质性降低了对治疗疗效的信心.
- 银杏花提取物显示出对认知和功能益处的最大希望,但临床意义和证据确定性较低.
- 未来的VCI试验需要专注于特定的亚型,强有力的机制性推理,标准化标准,足够的功率,安慰剂对照和数据共享.
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