非甾体类抗炎药在围术期使用的心血管事件风险的Meta分析

发布时间：2018-12-16 02:34

【摘要】：目的评价在围术期使用非甾体类抗炎药(NSAIDs)的心血管不良事件的风险。方法计算机检索PubMed、Web of Science、Medline、Cochrane Library、CNKI和万方数据库中正式发表的中英文文献,收集NSAIDs在围术期使用的随机对照试验(RCT),前瞻性队列研究和回顾性研究等,通过心血管不良事件(心肌梗死、心绞痛、心肌缺血、心律失常)的发生情况来评价NSAIDs的心血管不良事件的风险。结果共纳入8篇文献15 623例患者,其中非选择性NSAIDs文献有5篇(n=13 019),选择性环氧化酶-2(COX-2)抑制剂文献有3篇(n=2 604)。NSAIDs在围术期使用减少了心血管不良事件的发生(OR=0.59,95%CI 0.45~0.77,P=0.000 1),非选择性NSAIDs在围术期使用减少了心血管不良事件的发生(OR=0.42,95%CI 0.31~0.58,P0.001),选择性COX-2抑制剂在围术期或短期使用增加了心血管不良事件的发生(OR=2.53,95%CI 1.26~5.09,P=0.009)。结论具有心血管风险的患者围术期建议使用非选择性NSAIDs。
[Abstract]:Objective to evaluate the risk of cardiovascular adverse events with non-steroidal anti-inflammatory drug (NSAIDs) during perioperative period. Methods the Chinese and English literature published in PubMed,Web of Science,Medline,Cochrane Library,CNKI and Wanfang database were searched by computer, and (RCT), prospective cohort studies and retrospective studies were collected from randomized controlled trials used by NSAIDs during perioperative period. Cardiovascular adverse events (myocardial infarction, angina pectoris, myocardial ischemia, arrhythmia) were used to evaluate the risk of cardiovascular adverse events in NSAIDs. Results A total of 15 623 patients were included in 8 articles, of which 5 were non-selective NSAIDs articles (nnm13 019). There were 3 papers on selective cyclooxygenase-2 (COX-2) inhibitor (nap2 604). NSAIDs used in perioperative period to reduce the incidence of adverse cardiovascular events (OR=0.59,95%CI 0.45 0. 77). The use of non-selective NSAIDs during perioperative period reduced the incidence of adverse cardiovascular events (OR=0.42,95%CI 0.31 0. 58% P0.001). Selective COX-2 inhibitors increased the incidence of adverse cardiovascular events during perioperative or short-term (OR=2.53,95%CI 1.265.09 P0. 009). Conclusion Non-selective NSAIDs. is recommended for patients with cardiovascular risk during perioperative period.
【作者单位】：南京医科大学第一附属医院麻醉科;
【分类号】：R619

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