不同冠心病患者药物涂层支架置入术后双抗血小板疗程的Meta分析

发布时间：2018-02-10 08:54

本文关键词： 冠心病双抗血小板药物涂层支架疗程随机对照试验 Meta分析　出处：《中国医院药学杂志》2017年10期 　论文类型：期刊论文

【摘要】：目的:系统评价不同冠心病患者药物涂层支架置入术后双抗血小板疗程的有效性和安全性。方法:检索MEDLINE、EMBASE和Cochrane Library数据库,获得冠心病患者药物涂层支架置入术后不同疗程双抗血小板治疗的随机对照试验,采用RevMan 5.2软件分别对性别、年龄、冠心病类型、是否合并糖尿病及置入不同药物涂层支架患者短疗程相对长疗程双抗血小板治疗的有效性和安全性进行Meta分析。结果:共检索到文献4 322篇,最终纳入9个随机对照试验,共30 244例患者。Meta分析显示非老年患者[RR1.42,95%CI(1.20~1.70)]、置入紫杉醇[RR1.70,95%CI(1.26~2.29)]和西罗莫司药物涂层支架[RR1.71,95%CI(1.07~2.74)]的患者短疗程相对长疗程可增加未合并出血的主要复合终点发生率,而不同性别、老年患者、冠心病类型、是否合并糖尿病及置入依维莫司和佐他莫司药物涂层支架的患者短疗程相对长疗程双抗血小板治疗的主要复合终点发生率无显著性差异。结论:临床在为冠心病患者制定药物涂层支架置入术后双抗血小板疗程时应结合患者个体情况进行综合评估,对于非老年患者、置入紫杉醇和西罗莫司药物涂层支架的患者可在指南推荐的基础上适当延长双抗血小板疗程。
[Abstract]:Objective: to evaluate the efficacy and safety of double antiplatelet therapy in patients with different coronary heart disease after drug-coated stenting. Methods: MEDLINE EMBASE and Cochrane Library databases were searched. A randomized controlled trial of double antiplatelet therapy in different courses after drug-coated stenting was obtained in patients with coronary heart disease. Sex, age and type of coronary heart disease were determined by RevMan 5.2 software. Meta analysis was performed on the efficacy and safety of short-course, relatively long course double-antiplatelet therapy in patients with diabetes mellitus and different drug-coated stents. Results: a total of 4,322 articles were retrieved and included in 9 randomized controlled trials. A total of 30,244 patients. Meta-analysis showed that in non-elderly patients [RR1.42C95 CI1.201.70], paclitaxel [RR1.709CI1.262.29] and sirolimus drug-coated stents [RR1.71C95 CI1.072.74], short course of treatment and relatively long course of treatment increased the incidence of major complex endpoints without bleeding, whereas in elderly patients with different genders, Type of coronary heart disease, There was no significant difference in the incidence of major complex endpoints in patients with diabetes mellitus and patients with Evirolimus and zomolimus drug-coated stents. Conclusion: there is no significant difference in the incidence of major complex endpoints in patients with chronic coronary heart disease (CHD). Patients should make a comprehensive assessment of the course of treatment of double antiplatelet after drug-coated stent implantation according to the individual condition of the patient. For non-elderly patients, patients with paclitaxel and sirolimus drug-coated stents may extend the course of double-antiplatelet therapy appropriately on the basis recommended by the guidelines.
【作者单位】：苏州大学附属第一医院药学部;
【基金】：国家自然科学基金资助项目(编号:81173132) 江苏省医学重点人才资助项目(编号:RC2011110) 苏州市科技计划项目(编号:SYS2011137)
【分类号】：R541.4

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