合并心房颤动的血液透析患者使用华法林的卒中与出血风险

发布时间：2018-06-16 23:36

本文选题：血液透析 + 心房颤动　；参考：《南昌大学》2017年硕士论文

【摘要】：背景和目的:在合并心房颤动(AF)的血液透析(HD)患者中,使用华法林行抗凝治疗所带来的获益与存在的风险备受争议。因此,我们此次所做的就是使用meta研究方法来分析华法林在这类人群中的卒中与出血风险,从而评价它的有效性与安全性。方法和结果:我们使用以下电子数据库检索相关文献:Cochrane Library、PubMed、Ovid、ISI和中国生物医学数据库,检索时间自数据库建立起到2014年10月份,检索没有语言的限制。文献的纳入标准是:(1)必须提供合并AF的HD患者使用或者没有使用华法林时卒中和出血的风险情况,(2)必须提供研究人群卒中和出血风险的风险比(HR)和95%置信区间(CI),(3)必须是队列研究。合并后的风险比(HRs)和95%置信区间(CIs)用逆方差分析方法获得,同时也进行了敏感性分析和发表偏倚。我们从检索出的所有文章中筛选出六篇符合纳入标准的文献,纳入人群共9816名。合并后的总HRs结果提示华法林并不能明显减少合并AF的HD患者的卒中发生率[HR=1.23,95%CI 0.80-1.87;P=0.347],同时,还提示存在更高的出血风险[HR=1.20,95%CI 1.03-1.39;P=0.019]。结论:这篇meta分析的结果不推荐常规使用华法林治疗合并AF的HD患者。
[Abstract]:Background and purpose: the benefits and risks of anticoagulant therapy using warfarin in patients with atrial fibrillation (AF) are controversial. Therefore, what we do is to use the meta approach to analyze Hua Falin's risk of stroke and bleeding in these groups and to evaluate its effectiveness and safety. Methods and results: we use the following electronic database to retrieve relevant literature: Cochrane Library, PubMed, Ovid, ISI and Chinese biomedical database. The retrieval time is established from the database to October 2014 to retrieve no language restrictions. The inclusion criteria of the literature are: (1) the use of HD patients with AF must be provided or not made. The risk of stroke and bleeding in warfarin, (2) must provide a risk ratio (HR) and 95% confidence interval (CI) for the risk of stroke and bleeding in the population, (3) must be a cohort study. The combined risk ratio (HRs) and the 95% confidence interval (CIs) are obtained by inverse analysis of variance, while the sensitivity analysis and publication bias are also carried out. In all the articles published, six articles were selected to conform to the inclusion criteria and included 9816 people. The combined total HRs results suggested that warfarin did not significantly reduce the incidence of [HR=1.23,95%CI 0.80-1.87 in HD patients with AF, P=0.347], and also suggested that there was a higher risk of bleeding [HR=1.20,95%CI 1.03-1.39; P=0.019]. Conclusion: the results of this meta analysis do not recommend the routine use of warfarin in the treatment of HD patients with AF.
【学位授予单位】：南昌大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R541.75;R459.5

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