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Xa因子抑制剂对心房颤动抗凝治疗疗效及安全性的荟萃分析

Meta-analysis of the efficacy and safety of factor Xa inhibitor anticoagulation in patients with atrial fibrillation

摘要:

目的 评价Xa因子抑制剂预防血栓和脑卒中的疗效及安全性.方法 计算机全面检索MEDLINE、Embase、万方、中国知网关于Xa因子抑制剂对心房颤动(房颤)患者抗凝治疗的随机对照试验(RCT),同时筛查纳入的参考文献.时间:1990年至2012年.由2名研究者对纳入文献的质量进行严格评价和资料提取,对符合标准的研究采用GRADEprofiler 3.6和Review manage 5.1软件进行分析.结果 共纳入7个RCT.荟萃分析结果显示:试验组(Xa因子抑制剂)与对照组(华法林或阿司匹林)相比,房颤患者脑卒中以及主要出血事件发生率差异具有统计学意义,结果分别为OR=0.57,95% CI0.41 ~0.80,P=0.001、OR=0.74,95% CI0.66 ~0.83,P<0.00001.结论 Xa因子抑制剂可以降低房颤患者脑卒中的发生率,其发生不良反应的风险也低于对照组.由于纳入的研究数量有限,随访时间不同,故仍需更多RCT来证实其疗效及安全性.

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abstracts:

Objective To evaluate the efficacy and safety of factor Xa inhibitor in preventing systemic embolism in patients with atrial fibrillation(AF).Methods A subsequent systematic literature search of MEDLINE,Embase,CNKI and Wanfang Data were searched for the randomized controlled trials (RCTs)of direct factor Xa inhibitor in preventing systemic embolism in patients with AF from the date of 1990 to 2012.The included studies were evaluated and extracted by two researchers,independently.The statistical analyses were performed by GRADE profiler 3.6 and Review manage 5.1.Results A total of 7 studies were identified.Meta-analysis showed that there were significant difference in preventing of stroke (OR =0.57,95 % CI 0.41 to 0.80,P =0.001)and major bleeding(OR =0.74,95 % CI 0.66 to 0.83,P<0.00001) Conclusion The current evidence shows that factor Xa inhibitor could decrease incidence of stroke with fewer side effects.Due to the limited quantity of the included studies and difference of follow-up time,we need more RCTs to identify the efficacy and safety of Factor Xa inhibitors.

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作者: 蒋小波 [1] 黄鹤 [1] 郭毅 [1] 杨帆 [1] 范阳 [1] 胡柯 [1] 熊亮 [1]
第一作者: 蒋小波
栏目名称: 临床研究
DOI: 10.3760/cma.j.issn.1007-6638.2013.01.015
发布时间: 2013-04-26
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