氯吡格雷联合阿司匹林治疗急性冠脉综合征疗效与安全性的Meta分析(1)
摘要：目的 系統评价氯吡格雷联合阿司匹林治疗急性冠脉综合征的疗效。方法 计算机检索英文数据库Embase、Pubmed、The Cochrane Library以及中文数据库CBM、CNKI和WanFang Data，搜集有关氯吡格雷联合阿司匹林治疗急性冠脉综合征的相关临床研究，且研究必须为随机对照试验(RCT)。检索时限从2008年1月～2019年1月。由三位评价员独立筛选文献、提取资料并评价纳入的各项临床研究之间的偏移风险[Tau2=0.00;Chi2=3.35;df=10(P=0.97);I2=0]后，运用RevMan 5.3软件进行Meta分析。结果 最终纳入11项临床研究，包括2518名患者。Meta分析结果显示：与单用阿司匹林相比，氯吡格雷联合阿司匹林能明显提高治疗的有效率[OR=3.12，95%CI(2.20，4.42)，P<0.00001]，其中部分研究报道了氯吡格雷联合 阿司匹林治疗急性冠脉综合征的同时，肌钙蛋白的含量出现了降低[OR=4.94，95%CI(1.77，13.79)，P=0.002];对报道中的不良反应(包括心血管事件的发生、血小板的降低、出血等)进行分析，差异无统计学意义(P>0.05)。结论 氯吡格雷联合阿司匹林能提高对患有急性冠脉综合征的患者的疗效，并且可能不增加不良反应的发生率。由于受纳入的临床研究质量的限制，上述结论还需通过更多的质量更高的研究予以验证。
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关键词：急性冠脉综合征;氯吡格雷;阿司匹林;Meta分析
中图分类号：R541.4 文献标识码：A DOI：10.3969/j.issn.1006-1959.2019.11.021
文章编号：1006-1959(2019)11-0076-05
Abstract：Objective To evaluate the efficacy of clopidogrel combined with aspirin in the treatment of acute coronary syndrome.Methods We searched the English database Embase， Pubmed， The Cochrane Library and Chinese database CBM， CNKI and WanFang Data， collect relevant clinical studies related to clopidogrel plus aspirin treatment of acute coronary syndrome， and studies must be randomized controlled trials (RCT). The search time limit is from January 2008 to January 2019. Three reviewers independently screened the literature， extracted the data， and evaluated the risk of migration between the included clinical studies [Tau2=0.00; Chi2=3.35; df=10 (P=0.97); I2=0] Meta analysis was performed using RevMan 5.3 software.Results Finally，11 clinical studies were included， including 2，518 patients. Meta-analysis showed that clopidogrel combined with aspirin significantly improved the efficacy of treatment compared with aspirin alone [OR=3.12， 95% CI (2.20， 4.42)，P<0.00001]， some of which reported chloropyrryl While germination combined with aspirin in the treatment of acute coronary syndrome， troponin content was reduced [OR=4.94， 95% CI (1.77， 13.79)，P=0.002]; adverse reactions reported (including cardiovascular events) The occurrence， thrombocytopenia， hemorrhage， etc. were analyzed，the difference was not statistically significant (P>0.05).Conclusion Clopidogrel combined with aspirin can improve the efficacy of patients with acute coronary syndrome and may not increase the incidence of adverse reactions. Due to the limitations of the quality of the included clinical studies， the above conclusions need to be verified by more quality studies., 百拇医药(梁道博 姚卜飞 夏双燕)
, http://www.100md.com
关键词：急性冠脉综合征;氯吡格雷;阿司匹林;Meta分析
中图分类号：R541.4 文献标识码：A DOI：10.3969/j.issn.1006-1959.2019.11.021
文章编号：1006-1959(2019)11-0076-05
Abstract：Objective To evaluate the efficacy of clopidogrel combined with aspirin in the treatment of acute coronary syndrome.Methods We searched the English database Embase， Pubmed， The Cochrane Library and Chinese database CBM， CNKI and WanFang Data， collect relevant clinical studies related to clopidogrel plus aspirin treatment of acute coronary syndrome， and studies must be randomized controlled trials (RCT). The search time limit is from January 2008 to January 2019. Three reviewers independently screened the literature， extracted the data， and evaluated the risk of migration between the included clinical studies [Tau2=0.00; Chi2=3.35; df=10 (P=0.97); I2=0] Meta analysis was performed using RevMan 5.3 software.Results Finally，11 clinical studies were included， including 2，518 patients. Meta-analysis showed that clopidogrel combined with aspirin significantly improved the efficacy of treatment compared with aspirin alone [OR=3.12， 95% CI (2.20， 4.42)，P<0.00001]， some of which reported chloropyrryl While germination combined with aspirin in the treatment of acute coronary syndrome， troponin content was reduced [OR=4.94， 95% CI (1.77， 13.79)，P=0.002]; adverse reactions reported (including cardiovascular events) The occurrence， thrombocytopenia， hemorrhage， etc. were analyzed，the difference was not statistically significant (P>0.05).Conclusion Clopidogrel combined with aspirin can improve the efficacy of patients with acute coronary syndrome and may not increase the incidence of adverse reactions. Due to the limitations of the quality of the included clinical studies， the above conclusions need to be verified by more quality studies., 百拇医药(梁道博 姚卜飞 夏双燕)