Neurology® Journal Club: Meta-Analysis of Randomized Controlled Trials on IV Thrombolysis in Patients With Minor Acute Ischemic Stroke.

The authors identified 9 reports encompassing 13 RCTs.

作者确定了9篇报告，涵盖了13个RCTs。

Multiple analytical approaches (Q and I2 measures, leave-out-one analyses, sensitivity analyses) were performed to address study heterogeneity.

采取了多种分析方法（Q和I2度量、逐一排除分析、敏感性分析）来解决研究的异质性。

Findings show that, compared with NT-SC, IVT was not significantly associated with excellent functional recovery poststroke (odds ratio 0.85, 95% CI 0.70-1.03).

研究结果显示，与NT-SC相比，IVT与中风后优秀功能恢复无显著关联（优势比0.85，95%置信区间0.70-1.03）。

IVT was associated with lower odds of achieving functional independence and higher odds of symptomatic intracranial hemorrhage and mortality at 90 days.

静脉溶栓治疗与较低的实现功能独立性的几率相关，并且在90天时有较高的症状性颅内出血和死亡率的几率。

A major strength is the study's exclusive inclusion of RCTs, which minimizes methodological heterogeneity and enhances internal validity.

该研究的一个主要优势是其专门包括了随机对照试验（RCTs），这最小化了方法学的异质性并增强了内部有效性。

Limitations include (1) small number of included studies precluding formal assessment of publication bias; (2) exclusion of observational or quasiexperimental studies, potentially overlooking valuable real-world evidence; (3) variability in the definition of minor AIS; and (4) insensitivity of conventional outcome measures such as the modified Rankin Scale to capture nonmotor functional deficits such as fatigue and return-to-work capability, which are highly relevant to patients with minor stroke but remain underrepresented in traditional assessments.

局限性包括：（1）纳入的研究数量较少，无法进行出版偏倚的正式评估；（2）排除了观察性或准实验性研究，可能会忽略有价值的现实世界证据；（3）对轻微急性缺血性卒中（minor AIS）的定义存在差异；以及（4）传统的结果测量方法，如改良Rankin量表，对捕捉非运动功能缺陷（如疲劳和恢复工作能力）不敏感，这些缺陷对轻微卒中患者来说非常重要，但在传统评估中仍然被低估。

In conclusion, this meta-analysissuggests that IVT does not confer additional benefit over NT-SC for minor nondisabling stroke.

总之，这项荟萃分析表明，对于轻微非致残性卒中，静脉溶栓（IVT）并不比非溶栓标准护理（NT-SC）带来额外的益处。

Future studies would benefit from incorporating broader, patient-centered functional outcomes to better capture the subtleties of disability in this patient population.

未来的研究将从纳入更广泛的、以患者为中心的功能结果中受益，以更好地捕捉这一患者群体中残疾的细微差别。