摘要
目的 应用快速卫生技术评估阿加曲班治疗急性缺血性脑卒中的有效性、安全性和经济性,为选择临床治疗决策提供循证参考。方法 计算机检索PubMed、Embase、Web of Science、Cochrane Library、CNKI、WanFang Data、VIP、SinoMed数据库及卫生技术评估相关网站,搜集阿加曲班治疗急性缺血性脑梗死的卫生技术评估报告、系统评价/Meta分析以及药物经济学研究,检索时限均从建库至2024年2月6日,由2名研究者独立筛选文献、提取资料并评价纳入研究的质量,对结果进行定性描述与分析。结果 共纳入文献21篇,其中系统评价/Meta分析15篇,药物经济学研究6篇。有效性分析结果显示,与安慰剂、常规治疗或其他药物(如阿替普酶)相比,阿加曲班能够提升临床有效率,并改善患者神经功能缺损评分,但少部分研究与当前结果不一致。安全性分析结果显示,阿加曲班单用或联合其他药物与对照组相比,并未增加全身性出血、颅内出血、死亡以及其他不良反应风险,安全性较好。经济性分析结果显示,阿加曲班联合常规治疗或阿加曲班联合尤瑞克林方案具有经济学优势。结论 阿加曲班治疗急性缺血性脑卒中总体有效性和安全性较好,阿加曲班联合常规治疗或阿加曲班联合尤瑞克林方案具有经济学优势。
Objective Rapid health technology assessment(HTA)was used to evaluate the efficacy,safety and economy of argatroban in the treatment of acute ischemic stroke,so as to provide evidence-based reference for clinical treatment decision making.Methods PubMed,Embase,Web of Science,Cochrane Library,CNKI,WanFang Data,VIP,SinoMed databases and HTA website were electronically searched to collect the HTA report,systematic review/Meta-analysis and pharmacoeconomic research of argatroban in the treatment of acute ischemic cerebral infarction from inception to February 6,2024.Two reviewers independently identified studies,extracted data,assessed the quality of included studies,and descriptively analyzed and summarised the results.Results A total of 21 articles were included,including 15 systematic reviews/Meta-analysis and 6 pharmacoeconomic studies.The analysis results of effectiveness showed that argatroban could improve the clinical effective rate,neurological deficit score compared with placebo,routine treatment,or other drugs(such as alteplase),but a few studies were inconsistent with the current results.The analysis results of safety showed that argatroban alone or in combination with other drugs did not increase the risk of systemic hemorrhage,intracranial hemorrhage,mortality and other adverse reactions compared with the control group,and had a favorable safety profile.The analysis results of pharmacoeconomic studies that argatroban combined with routine treatment or argatroban combined with urokinase had economic advantages.Conclusion Argatroban is generally effective and safe in the treatment of acute ischemic stroke,and it has economic advantages for patients to choose argatroban combined with routine treatment or urokinase treatment.
作者
庄志江
张强
陈子佳
张丽红
ZHUANG Zhijiang;ZHANG Qiang;CHEN Zhijia;ZHANG Lihong(Department of Neurology,The Fifth Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;Department of Gastroenterology,The First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450000,China;Institute of Basic Research in Clinical Medicine,China Academy of Chinese Medicine Sciences,Beijing 100700,China;Department of Integrated Chinese and Western Medicine,Henan Cancer Hospital Affiliated to Zhengzhou University,Zhengzhou 450000,China)
出处
《药物流行病学杂志》
CAS
2024年第5期549-560,共12页
Chinese Journal of Pharmacoepidemiology
基金
河南省医学科技厅科技攻关计划项目(LHGJ20230402)
河南省高校重大科研项目(23A360011)。
