肝素联合阿司匹林治疗抗磷脂抗体引起的复发性流产妊娠结局的Meta分析

发布时间：2018-11-27 11:14

【摘要】：目的：有多项临床试验提出肝素联合阿司匹林较单用阿司匹林治疗抗磷脂抗体综合征(antiphospholipid syndrome,APS)导致的复发性流产的效果更好，本研究搜集所有关于肝素联合阿司匹林治疗APS引起的复发性流产的随机对照试验进行Meta分析，以此来评价肝素联合阿司匹林治疗APS引起的复发性流产的疗效和安全性，从而为临床治疗复发性流产提供可靠的循证医学证据。方法：在数据库中如PubMed、MEDLINE、E M BASE和相关期刊论文检索以APS引起的复发性流产患者为研究对象，并进行了肝素联合阿司匹林（联合组）与单用阿司匹林（对照组）比较的随机对照试验（randomized controlled trial,RCT）研究，对符合入选标准的文献对其疗效和安全性进行Meta分析。结果：共有9篇文献符合入选标准，并进行了疗效和安全性的评价。联合组的新生儿出生率明显升高，RR=1.32，95%CI[1.22,1.42]，P0.00001，差异有统计学意义。联合组新生儿体重、早产率、胎儿生长受限、子痫前期发生率、出血情况较治疗组无统计学差异。结论：联合应用肝素和阿司匹林较单用阿司匹林治疗APS阳性的复发性流产可提高活产率，同时不会增加早产、胎儿生长受限、子痫前期以及出血的风险。
[Abstract]:Objective: several clinical trials have suggested that heparin combined with aspirin is more effective than aspirin alone in the treatment of recurrent abortion induced by anti-phospholipid antibody syndrome (antiphospholipid syndrome,APS). In order to evaluate the efficacy and safety of heparin combined with aspirin in the treatment of recurrent abortion induced by APS, we collected all randomized controlled trials of heparin combined with aspirin to evaluate the efficacy and safety of Meta analysis in the treatment of recurrent abortion caused by APS. So as to provide reliable evidence-based medical evidence for the clinical treatment of recurrent abortion. Methods: in databases such as PubMed,MEDLINE,E M BASE and Chinese Journal Full-text Database, the patients with recurrent abortion caused by APS were studied. A randomized controlled trial (randomized controlled trial,RCT) study of heparin combined with aspirin (combined group) and single aspirin (control group) was carried out. Meta analysis was performed on the efficacy and safety of heparin combined with aspirin. Results: a total of 9 articles met the inclusion criteria and evaluated the efficacy and safety. The birth rate of newborns in the combined group was significantly higher, RR=1.32,95%CI [1.22 卤1.42], P 0.00001, the difference was statistically significant. There was no significant difference in neonatal weight, premature delivery rate, fetal growth restriction, preeclampsia and bleeding in the combined group. Conclusion: the combination of heparin and aspirin in the treatment of APS positive recurrent abortion can increase the rate of live delivery without increasing the risk of premature delivery, fetal growth restriction, preeclampsia and hemorrhage.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R714.21

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