摘要
目的系统评价阿司匹林联合氯吡格雷对进展性卒中疗效、安全性以及血清hs-CRP影响。方法检索中国知网、中国生物医学文献数据库、万方数据库、维普期刊数据库、PubMed、Embase、Cochrane Library 2013-2017年文献。根据Cochrane系统评价方法对纳入的研究进行质量评价,并用RevMan5.3软件进行Meta分析。结果23篇文献,共2189例患者纳入统计分析。Meta分析显示:阿司匹林+氯吡格雷组治疗后患者的有效率明显髙于阿司匹林组(OR=4.68,95%CI3.54~6.19,P<0.00001);神经功能缺损程度评分显著低于阿司匹林组(MD=-4.04,95%CI-4.80~3.28,P<0.00001);血清hs-CRP水平明显低于阿司匹林组(MD=-3.20,95%CI-3.44~2.96,P<0.00001);出血发生率高于阿司匹林组(OR=2.87,95%CU.17~7.01,P=0.02)。结论阿司匹林联合氯吡格雷对进展性卒中疗效较好,但同时出血风险也高,应谨慎选择适应人群。
AIM To systematically evaluate the efficacy and safety of aspirin combined with clopidogrel (combination group) in the treatment of progressive stroke.METHODS The databases of CNKI, CBM, Wan-fang,VIP,PubMed,Embase and Cochrane Library were searched from 2013 to 2017.The included studies were valuated by the Cochrane system evaluation methods.Meta-analysis was conducted by RevMan 5.3 software.RESULTS A total of 23 studies, 2 189 patients were included in the meta-analysis.The results showed that the effective rate was higher in the combination group( OR =4.68 ,95% CI 3.54 -6.19 ,P < 0.00001 ).The neurologic impairment score was significantly lower in the combination group( MD =-4.04,95% CI -4.80 - 3.28 ,P <0.000 01 ).Serum hs-CRP level was lower in the combination group after treatment ( MD =- 3.20 ,95% CI -3.44 - 2.96 ,P< 0.00001 ).However the incidence of hemorrhage was higher in the combination group ( OR =2.87,95% CI1.17- 7.01 ,P= 0.02).CONCLUSION Aspirin combined with clopidogrel is more efficacy in the treatment of progressive stroke, however the incidence of hemorrhage is also higher.It is important to recognize the eligible patients for the combination therapy.
作者
潘希丁
唐慕菲
PAN Xiding;TANG Mufei(Department of Pharmacy,Nanjing First Hospital-Nanjing Medical University,Nanjing 210006,China)
出处
《中国临床药学杂志》
CAS
2019年第3期213-218,共6页
Chinese Journal of Clinical Pharmacy
基金
南京医科大学科技发展基金(编号2013NJMU072)
