阿司匹林与氯吡格雷预防或治疗缺血性脑卒中致出血并发症的系统评价
发布时间：2019-03-26 09:30
【摘要】：目的对阿司匹林与氯吡格雷预防或治疗缺血性脑卒中(IS)导致出血并发症风险进行评价。方法计算机检索Pub Med、EMBase、The Cochrane Library、CBM、CNKI、VIP和Wang Fang Data等数据库。检索自建库截止至2016年9月。搜集阿司匹林与氯吡格雷预防或治疗IS且产生出血并发症的随机对照试验(RCT)。由2位研究人员独立进行文献筛选、数据提取和质量评价后,采用Rev Man 5.2软件进行Meta分析。结果共纳入13个RCT,包括5204例患者。Meta分析结果显示:(1)预防IS时,阿司匹林相比氯吡格雷不增加皮肤黏膜、牙龈出血风险,但增加消化道出血风险;阿司匹林和氯吡格雷联用相比阿司匹林单用增加胃肠道反应。(2)治疗IS时,阿司匹林相比氯吡格雷不增加皮肤黏膜、牙龈、消化道出血风险,不增加胃肠道反应;阿司匹林和氯吡格雷联用相比阿司匹林单用亦不增加皮肤黏膜、牙龈、消化道、颅脑出血风险,不增加胃肠道反应。结论预防IS时,阿司匹林相比氯吡格雷会增加消化道出血风险,阿司匹林和氯吡格雷联用相比阿司匹林单用会增加胃肠道反应。
[Abstract]:Objective To evaluate the risk of hemorrhagic complications caused by the prevention or treatment of ischemic stroke (IS) by aspirin and chlordecay. Methods The databases of Pub Med, EMBase, The Cochrane Library, CBM, CNKI, VIP and Wang Fang Data were retrieved from the computer. The self-built library was retrieved until September 2016. A randomized controlled trial (RCT) for the prevention or treatment of IS and the occurrence of bleeding complications with aspirin and chloringray. Literature screening, data extraction and quality evaluation were carried out independently by two researchers, and Meta-analysis was carried out by using the Rev Man 5.2 software. Results A total of 13 RCTs were included, including 5204 patients. The results of the meta-analysis showed that: (1) In the prevention of IS, the risk of bleeding of the gingival bleeding was not increased compared with that of the chloringray, but the risk of the bleeding of the digestive tract was increased; and the combination of the aspirin and the chloroforgrel alone increased the gastrointestinal reaction. (2) In the treatment of IS, the risk of the skin mucosa, the gum, the digestive tract and the bleeding of the digestive tract is not increased as compared with the aspirin, and the gastrointestinal reaction is not increased; and the combination of the aspirin and the chlorhexidine gluconate does not increase the risk of the skin mucous membrane, the gum, the digestive tract and the head bleeding, The gastrointestinal reaction is not increased. Conclusion In the prevention of IS, aspirin may increase the risk of bleeding in the digestive tract, compared with the use of aspirin alone, and the use of aspirin alone will increase the gastrointestinal reaction.
【作者单位】： 克拉玛依市中心医院神经内科;克拉玛依市中心医院药剂科;四川大学华西医院循证医学中心;
【基金】：克拉玛依市科委立项项目(JK2014-18)
【分类号】：R743.3
本文编号：2447415
[Abstract]:Objective To evaluate the risk of hemorrhagic complications caused by the prevention or treatment of ischemic stroke (IS) by aspirin and chlordecay. Methods The databases of Pub Med, EMBase, The Cochrane Library, CBM, CNKI, VIP and Wang Fang Data were retrieved from the computer. The self-built library was retrieved until September 2016. A randomized controlled trial (RCT) for the prevention or treatment of IS and the occurrence of bleeding complications with aspirin and chloringray. Literature screening, data extraction and quality evaluation were carried out independently by two researchers, and Meta-analysis was carried out by using the Rev Man 5.2 software. Results A total of 13 RCTs were included, including 5204 patients. The results of the meta-analysis showed that: (1) In the prevention of IS, the risk of bleeding of the gingival bleeding was not increased compared with that of the chloringray, but the risk of the bleeding of the digestive tract was increased; and the combination of the aspirin and the chloroforgrel alone increased the gastrointestinal reaction. (2) In the treatment of IS, the risk of the skin mucosa, the gum, the digestive tract and the bleeding of the digestive tract is not increased as compared with the aspirin, and the gastrointestinal reaction is not increased; and the combination of the aspirin and the chlorhexidine gluconate does not increase the risk of the skin mucous membrane, the gum, the digestive tract and the head bleeding, The gastrointestinal reaction is not increased. Conclusion In the prevention of IS, aspirin may increase the risk of bleeding in the digestive tract, compared with the use of aspirin alone, and the use of aspirin alone will increase the gastrointestinal reaction.
【作者单位】： 克拉玛依市中心医院神经内科;克拉玛依市中心医院药剂科;四川大学华西医院循证医学中心;
【基金】：克拉玛依市科委立项项目(JK2014-18)
【分类号】：R743.3
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