摘要
目的:系统评价中国急性冠状动脉综合征(acute coronary syndrome,ACS)患者应用替格瑞洛联合阿司匹林与氯吡格雷联合阿司匹林治疗的疗效和安全性。方法:系统检索Embase、PubMed、中国期刊全文数据库、中国生物医学文献数据库及万方数据库检索,搜集有关中国ACS患者应用替格瑞洛联合阿司匹林与氯吡格雷联合阿司匹林治疗的疗效和安全性比较的随机对照试验(randomized controlled trials,RCT),采用RevMan 5.3软件进行Meta分析。结果:纳入18项RCT共2925例患者。Meta分析结果显示:与氯吡格雷组相比,替格瑞洛组在随访期间主要心血管不良事件(OR=0.23,95%CI:0.15~0.36,P<0.05)、心肌梗死(OR=0.29,95%CI:0.16~0.53,P<0.05)、脑卒中的发生率(OR=0.26,95%CI:0.13~0.54,P<0.05)、临床效果(OR=3.86,95%CI:2.04~7.31,P<0.05)均显著降低,但呼吸困难发生率(OR=4.42,95%CI:2.61~7.51,P<0.05)较氯吡格雷组高。结论:中国ACS患者应用替格瑞洛联合阿司匹林可显著降低主要心血管不良事件、心肌梗死和卒中的发生率,但须警惕呼吸困难事件的发生。
Objective:To systematically evaluate the efficacy and safety of ticagrelor plus aspirin and clopidogrel in combination with aspirin in Chinese patients with acute coronary syndrome(ACS).Methods:The data of Embase,PubMed,CNKI,CBM and Wanfang database were searched systematically to collect data about the treatment of ACS patients treated with ticagrelor combined with aspirin plus clopidogrel in combination with aspirin efficacy and safety comparison of randomized controlled trials(RCT),using RevMan 5.3 software for Meta-analysis.Results:A total of 2925 patients were enrolled in 18 RCTs.Meta-analysis showed that major adverse cardiac events(MACE)(OR=0.23,95%CI:0.15-0.36,P<0.05),myocardial infarction(OR=0.29,95%CI:0.16-0.53,P<0.05).The incidence of stroke(OR =0.26,95%CI:0.13-0.54,P<0.05),Clinical effect(OR=3.86,95%CI:2.04-7.31,P<0.05),but the incidence of dyspnea(OR =4.42,95%CI:2.61-7.51,P<0.05)was higher than that of the clopidogrel group.Conclusion:The use of ticagrelor plus aspirin in ACS patients in China can significantly reduce the incidence of major cardiovascular adverse events,myocardial infarctions and strokes,but beware of the occurrence of dyspnea events.
作者
赵妍
郑丽
刘德平
ZHAO Yan;ZHENG Li;LIU De-ping(Department of Pharmacy ,731 Hospital of China Aerospace Science and Industry Corporation, Beijing 100074, China;Department of Cardiovascular ,Beijing Hospital,National Center of Gerontology,Beijing 100730, China)
出处
《临床药物治疗杂志》
2019年第6期25-31,共7页
Clinical Medication Journal
