摘要
目的评估利伐沙班与传统抗凝方案对冠脉事件发生率的影响。方法检索英文医学数据库PubMed、Medline、Cochrane,根据纳入和排除标准进行文献检索与筛选。采用改良的Jadad量表对纳入文献进行评价,使用Revman 5.3软件进行Meta分析,比较利伐沙班与传统抗凝方案对主要有效性终点栓塞事件、主要安全性终点大出血相关事件以及冠脉事件(心肌梗死等)的发生风险。结果本研究共检索到118篇文献,最终纳入8篇随机对照试验,共涉及32 029例患者。其中,利伐沙班组15 993例,传统抗凝组16 036例。利伐沙班组栓塞性事件的发生率显著低于传统抗凝组,差异有统计学意义[比值比(OR)=0.60,95%可信区间为0.53~0.67,P<0.05]。两组在大出血事件的发生率方面比较,差异无统计学意义(OR=1.01,95%可信区间为0.94~1.09,P>0.05)。与传统抗凝组相比较,利伐沙班组冠脉事件的发生率呈减少趋势,但两组间比较,差异无统计学意义(OR=0.82,95%可信区间为0.63~1.02,P>0.05)。结论利伐沙班在降低栓塞事件的发生率方面明显优于传统抗凝方案,且不增加大出血风险。
Objective To assess the coronary risk of rivaroxaban and conventional anticoagulant treatment. Methods English medi- cal database was reviewed and screened from PubMed, Medline and Coehrane, based on inclusion and exclusion criteria. Modified Jadad scale was used to evaluate literature, using Revman 5.3 software to carry on the system analysis, compared the rivarosaban with traditional anticoagulation treatment for main efficacy end point, the main safety end bleeding related events and risk of coronary events （myocardial infarction）. Results A total of 118 literatures were retrieved and 8 randomized controlled trials were included in the study,involving 32 029 patients. There were 15 993 cases in rivarosaban group and 16 036 cases in traditional anticoagulation group. There was a significantly lower risk of embolism events in the rivarosaban group, （ OR = 0. 60,95 % CI： 0. 53-0.67, P 〈 0. 05 ）. There was no statistically significant difference between the two groups in the incidence of major bleeding events, （ OR = 1.01,95% CI：0. 94- 1.09 ,P 〉 0. 05 ）. Compared with the traditional anticoagulation group, the incidence of coronary events in rivaroxaban group reduced, while there was no statistically significant difference between the two groups, （ OR = 0. 82, 95% CI： 0. 63-1.02, P 〉 0. 05 ）. Conclusion Rivaroxaban is significantly more effective than conventional anticoagulant treatment and does not increase the risk of major bleeding events.
作者
李楠
赵庆春
党大胜
LI Nan, ZHAO Qing-chun, DANG Da-sheng(Department of Clinical Pharmacy, Shenyang Pharmaceutical University, Shenyang 110016, Chin)
出处
《临床军医杂志》
CAS
2018年第3期258-262,共5页
Clinical Journal of Medical Officers
关键词
利伐沙班
抗凝
冠脉事件
META分析
Rivaroxaban
Anticoagulation
Coronary event
Meta analysis
