摘要
目的系统性评价经皮冠脉介入(PCI)术后应用不同剂量氯吡格雷预防心血管事件的有效性和安全性,为指导临床决策提供依据。方法计算机检索Pubmed-Medline、Cocharne Library、CNKI、万方数据库,手工检索有关引用文献,并结合文献追溯的方法,收集国内外公开发表的有关PCI术后应用氯吡格雷的随机对照试验(RCT)。采用RevMan4.2作荟萃分析。结果共检索到相关文献765篇排除759篇,纳入符合标准的6篇文献进行分析,共计1 027例患者。分析结果示:与75mg氯吡格雷常规维持剂量相比,150 mg的高维持剂量明显降低心脑血管事件发生率(OR=0.52,95%CI 0.36,0.77);在严重并发症方面高维持剂量不增加严重出血风险(OR=1.25,95%CI 0.43,3.63)和次要出血风险(OR=1.25,95%CI 0.77,2.02)。结论氯吡格雷对血小板的抑制作用呈时间和剂量依赖性,可以通过增加氯吡格雷的剂量抑制血小板功能,减少PCI术后心血管不良事件的风险,且不会增加出血的风险。
Objective To make a comprehensive evaluation of the efficacy and safety of different doses of clopidogrel that was used after percutaneous coronary intervention（PCI） in preventing the cardiovascular events in order to provide scientific basis for physician in making therapeutic strategic decision.Methods The authors searched the electronic databases（PubMed,Cochrane Central Register of Controlled Trials,CNKI and Wan Fan） and reference lists from original studies and reviewed the related articles.Statistical analysis was performed by using RevMan 4.2 sofeware.Results A total of 6 studies containing 1027 patients were included.The results of meta-analysis showed that significant differences in the rate of cardiovascular events [OR = 0.52,95%CI（0.36,0.77）] existed between higher clopidogrel maintenance dose and standard dose.No obvious difference was found in major or minor bleeding [OR=1.25,95%CI（0.43,3.63）] and [OR = 1.25,95%CI（0.77,2.02）].Conclusion A higher maintenance dose of clopidogrel employed in patients undergoing PCI can reduce the occurrence of cardiovascular events after PCI without increasing the bleeding risk.
出处
《介入放射学杂志》
CSCD
北大核心
2011年第2期97-102,共6页
Journal of Interventional Radiology
关键词
氯吡格雷
经皮冠脉介入术
心血管事件
荟萃分析
clopidogrel
percutaneous coronary intervention
cardiovascular events
Meta-analysis
