达比加群酯抗凝治疗安全性的系统评价

发布时间：2018-01-31 00:29

本文关键词： 达比加群酯对照药安全性系统评价　出处：《中国临床药理学杂志》2015年24期 　论文类型：期刊论文

【摘要】：目的系统评价达比加群酯抗凝治疗的安全性。方法检索PubMed、ClinicalTrials.gov、中国知网等数据库中关于达比加群酯治疗各类栓塞疾病的随机对照研究,截至2015年6月。用Stata 13.1及Rev Man 5.3软件进行Meta分析。结果共纳入16项随机对照研究,总计42395例患者。达比加群酯相比对照药可显著降低严重出血发生率(P0.05),尤其是与华法林相比结果显著(P0.01),但随剂量增加,达比加群酯严重出血发生率呈现增高趋势。达比加群酯可显著增加心肌梗死发生率(P0.01),其中与华法林比较结果显著(P0.01),且达比加群酯心肌梗死发生率与剂量呈正相关。达比加群酯可显著增加消化道出血发生率(P0.01),与华法林或安慰剂相比结果更为显著(P0.05),且达比加群酯消化道出血发生率与剂量呈正相关。漏斗图检测不存在发表偏倚,敏感性分析证实结果可靠。结论达比加群酯可引起心肌梗死和消化道出血风险高,临床使用中需充分权衡利弊。
[Abstract]:Objective to systematically evaluate the safety of dabib plus group ester in anticoagulant therapy. Methods PubMedtros ClinicalTrials.gov was searched. A randomized controlled study on the treatment of various types of embolism diseases with Darby plus group ester in databases such as China.com. As of June 2015, Meta analysis was performed with Stata 13.1 and Rev Man 5.3 software. The results were included in 16 randomized controlled trials. A total of 42395 patients. Compared with the control group, dapi plus group ester could significantly reduce the incidence of severe hemorrhage, especially compared with warfarin, the results were significant (P 0.01), but with the increase of dosage. The incidence of severe hemorrhage of dapi plus group ester showed an increasing trend, and the incidence of myocardial infarction was significantly increased by dapi plus group ester, and the results were significant compared with warfarin (P 0.01). There was a positive correlation between the incidence of myocardial infarction and the dosage of dabib plus group ester, which could significantly increase the incidence of gastrointestinal hemorrhage (P 0.01). Compared with warfarin or placebo, the results were more significant (P 0.05), and there was a positive correlation between the incidence of gastrointestinal hemorrhage and the dose of dabiquin. There was no publication bias in funnel imaging. Conclusion the risk of myocardial infarction and gastrointestinal hemorrhage caused by dabib plus group ester is high, and it is necessary to weigh the advantages and disadvantages in clinical use.
【作者单位】：北京医院药学部;北京大学医学部药学院药事管理与临床药学系;
【分类号】：R969.4
【正文快照】： (1.北京医院药学部,北京100730;2.北京大学医学部药学院药事管理与临床药学系,北京100191)SUN Xiu-bo1,2,TIE Yuan1,2,CHEN Qing1,2,HE Yi-chen1,2,LIU Lei1(1.Department of Pharmacy,BeijingHospital,Beijing 100730,China;2.Department of Pharmacy Administra-tion and Cl

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