利伐沙班治疗深静脉血栓有效性和安全性的Meta分析

发布时间：2019-04-02 11:40

【摘要】：目的评价利伐沙班在治疗深静脉血栓方面的有效性和安全性。方法系统检索Pub Med、Em Base、Cochrane Library、Web of Science、Clinical Trials、中国知网(CNKI)、中国生物医学文献数据库(CBM)、万方数据库,检索时间均从建库至2016年8月。筛选出利伐沙班单药或者联合其他常规用药治疗深静脉血栓的所有随机对照试验(randomized controlled trials,RCTs),比较深静脉血栓复发、静脉血栓栓塞复发、肺栓塞、大出血、临床相关非大出血、死亡等终点事件的发生率。结果以相对危险系数(risk ratio,RR)及其95%置信区间(confidence interval,CI)表示,用Rev Man 5.3软件进行Meta分析。结果共纳入5项RCTs研究,共纳入4 737例患者,其中干预组1 605例,对照组3 132例。Meta分析结果显示,与肝素/低分子肝素+维生素K拮抗剂(UFH/LMWH+VKA)相比,在深静脉血栓复发率方面,试验组显著低于对照组(P=0.002);在肺栓塞、静脉血栓栓塞、大出血、临床相关非大出血、死亡发生率等方面均无显著差异(P0.05)。结论利伐沙班治疗深静脉血栓的疗效优于传统的抗凝治疗方式(UFH/LMWH+VKA),且不会增加大出血、死亡等风险。
[Abstract]:Objective to evaluate the efficacy and safety of rivastatin in the treatment of deep venous thrombosis (DVT). Methods the database of (CBM), Wanfang, (CNKI), of Pub Med,Em Base,Cochrane Library,Web of Science,Clinical Trials, China knowledge Network, was searched from August 2016 to August 2016. The retrieval time of the database was from August 2016 to August 2016. All randomized controlled trials (randomized controlled trials,RCTs) were selected for the treatment of deep venous thrombosis (DVT) with rivastatin monotherapy or combined with other conventional drugs, and to compare the recurrence of deep venous thrombosis (DVT), the recurrence of venous thromboembolism (VT), pulmonary embolism (PE), and massive hemorrhage (DVT). Incidence of clinical-related non-massive bleeding, death, and other end-point events. Results expressed as relative risk coefficient (risk ratio,RR) and 95% confidence interval (confidence interval,CI), Meta analysis was performed with Rev Man 5.3 software. Results A total of 4 737 patients were enrolled in 5 RCTs studies, including 1 605 patients in the intervention group and 3 132 in the control group. Meta-analysis showed that compared with heparin / low molecular weight heparin vitamin K antagonist (UFH/LMWH VKA), the results of meta-analysis showed that there was no significant difference between the intervention group and the control group. The recurrence rate of deep venous thrombosis in the experimental group was significantly lower than that in the control group (P < 0.002). There was no significant difference in pulmonary embolism, venous thromboembolism, massive hemorrhage, clinical related non-massive hemorrhage and death rate (P0.05). Conclusion Levaraban is more effective than traditional anticoagulation therapy (UFH/LMWH VKA),) in the treatment of deep venous thrombosis (DVT) and does not increase the risk of massive hemorrhage and death.
【作者单位】：北京大学第三医院药剂科;
【分类号】：R543.6

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