比较华法林与阿司匹林用于预防窦性心律心力衰竭患者血栓形成的有效性及安全性的Meta分析

发布时间：2018-02-11 22:41

本文关键词： Meta分析心力衰竭窦性心律血栓形成　出处：《广西医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:探索窦性心律心力衰竭患者最佳的预防血栓形成的方案。方法:对PubMed、EMbase、CNKI、VIP、万方等数据库进行检索,搜集有关比较窦性心律心力衰竭患者使用华法林与阿司匹林进行预防血栓形成的研究,并对搜集到的文章进行综合定量评价,应用Rev Man5.3软件对所收集的文献进行Meta分析,观察的终点事件指标包括:全因死亡、缺血性脑卒中、心肌梗死、大出血事件、中枢神经系统出血、小出血事件、不良胃肠道反应等。结果:共纳入6篇文献,累计病例3662例,其中华法林组1824例,阿司匹林组1838例。meta分析结果提示,在预防窦性心律心力衰竭患者血栓形成的药物中,华法林组与阿司匹林组在全因死亡(RR=1.01,95%CI0.89~1.14,P=0.88)、心肌梗死(RR=1.09,95%CI 0.74~1.61,P=0.67)、因心衰住院(RR=0.90,95%CI 0.64~1.26,P=0.60)、中枢神经系统出血(RR=1.34,95%CI 0.63~2.82,P=0.45)、包括出血在内的不良胃肠道反应(RR=1.10,95%CI 0.23~5.30,P=0.91)的发生率的比较上无统计学差异。在缺血性脑卒中的发生率比较上,华法林显著低于阿司匹林(RR=0.49,95%CI 0.33~0.73,P=0.0005);然而,在大出血(RR=1.93,95%CI 1.38~2.68,P=0.0001)、小出血(RR=1.37,95%CI 1.11~1.68,P=0.003)的发生率上,华法林亦明显高于阿司匹林。结论:在预防窦性心律心力衰竭患者血栓形成的治疗中,与阿司匹林相比,华法林治疗后缺血性脑卒中的发生率更低,但小出血事件、大出血事件的发生率更高。
[Abstract]:Objective: to explore the best scheme to prevent thrombosis in patients with sinus heart failure. A comparative study on the use of warfarin and aspirin in prevention of thrombosis in patients with sinus heart failure was collected. The collected articles were evaluated quantitatively and analyzed by Meta using Rev Man5.3 software. The endpoint events included: total death, ischemic stroke, myocardial infarction, massive hemorrhage, central nervous system hemorrhage, small hemorrhage events, adverse gastrointestinal reactions, etc. Results: a total of 6 literatures were included, with a total of 3662 cases. The results of meta analysis in the warfarin group (1824 cases) and aspirin group (1838 cases) suggested that in the prevention of thrombosis in patients with sinus heart failure, There was no statistical difference between warfarin group and aspirin group in the incidence of RRN 1.01c95CI0.89 1.14P0.88, myocardial infarction 1.0995CI 0.749.95 CI 0.741P0.67m, RRRN 0.9095 CI 0.641.26P0.60, central nervous system hemorrhage 1.34495CI 0.632.82P0.45, including hemorrhage. There was no statistical difference in the incidence of adverse gastrointestinal reaction (RRN 1.1095CI 0.235.30P0.91). Compared with the incidence of ischemic stroke, Warfarin was significantly lower than that of Aspirin RRN 0.4995 CI 0.330.73 P0. 0005; however, warfarin was also significantly higher than aspirin in the incidence of RRN 1.9395 CI 1.38C 2.68 P0.0001, RRN 1.37 ~ 95CI 1.111.68 P0.003). Conclusion: in the treatment of prevention of thrombosis in patients with sinus heart failure, warfarin is also significantly higher than aspirin in the prevention of thrombosis in patients with sinus heart failure. Compared with aspirin, the incidence of ischemic stroke after warfarin treatment was lower, but the incidence of small hemorrhage events and massive hemorrhage events was higher.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R541.6

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