期刊文献+

替格瑞洛对比氯吡格雷治疗急性冠状动脉综合征有效性与安全性的Meta分析 预览

Meta-analysis of Efficacy and Safety of Ticagrelor versus Clopidogrel in the Treatment of Acute Coronary Syndrome
在线阅读 下载PDF
分享 导出
摘要 目的:系统评价替格瑞洛对比氯吡格雷治疗急性冠状动脉综合征(ACS)的有效性和安全性,旨在为临床用药提供循证参考。方法:计算机检索PubMed、Embase、Cochrane图书馆、中国生物医学文献光盘数据库、中国期刊全文数据库等,收集替格瑞洛(试验组)对比氯吡格雷(对照组)治疗ACS的随机对照试验(RCT)。筛选文献、提取资料并采用改良Jadad量表评价质量后,采用Rev Man 5.3软件进行Meta分析。结果:共纳入26项RCT,合计8 560例患者。Meta分析结果显示,试验组患者主要不良心脏事件发生率[RR=0.47,95%CI(0.38,0.57),P<0.000 01]、脑卒中发生率[RR=0.24,95%CI(0.08,0.69),P=0.008]、血小板聚集率[SMD=-3.16,95%CI(-4.16,-2.16),P<0.000 01]、C反应蛋白水平[SMD=-1.02,95%CI(-1.76,-0.29),P=0.006]均显著低于对照组,尿酸水平[SMD=0.64,95%CI(0.39,0.88),P<0.000 01]显著高于对照组;两组患者主要出血事件发生率[RR=0.96,95%CI(0.66,1.40),P=0.85]、呼吸困难发生率[RR=1.19,95%CI(0.78,1.80),P=0.42]比较,差异均无统计学意义。结论:替格瑞洛治疗ACS的疗效和安全性均优于氯吡格雷,但可引起尿酸升高。 OBJECTIVE:To systematically evaluate the efficacy and safety of ticagrelor versus clopidogrel in the treatment of acute coronary syndrome(ACS).METHODS:Retrieved from PubMed,Embase,Cochrane Library,CBM and CNKI,randomized controlled trials(RCTs)about ticagrelor(trial group)and clopidogrel(control group)in the treatment of ACS were included.After literature screening,data extraction and quality evaluation with modified Jadad scale,Meta-analysis was performed by using Rev Man 5.3 software.RESULTS:26 RCTs were included,involving 8 560 patients.Meta-analysis showed that the incidence of main adverse cardiac event[RR=0.47,95%CI(0.38,0.57),P<0.000 01]and stroke[RR=0.24,95%CI(0.08,0.69),P=0.008],platelet aggregation rate[SMD=-3.16,95%CI(-4.16,-2.16),P<0.000 01]and C-reactive protein level[SMD=-1.02,95%CI(-1.76,-0.29),P=0.006]in trial group were significantly lower than control group;uric acid level[SMD=0.64,95%CI(0.39,0.88),P<0.000 01]of trial group was significantly higher than control group.There was no statistical significance in the incidence of main bleeding event[RR=0.96,95%CI(0.66,1.40),P=0.85]or dyspnea[RR=1.19,95%CI(0.78,1.80),P=0.42]between 2 groups.CONCLUSIONS:The efficacy and safety of ticagrelor is superior to those of clopidogrel in treatment of ACS,but ticagrelor can cause the elevation of uric acid.
作者 姚斌 李国武 刘瑞 雷鸣 YAO Bin;LI Guowu;LIU Rui;LEI Ming(Dept.of Internal Medicine,Ningxia Hui Autonomous Region Zhongning County Hospital of TCM,Ningxia Zhongning 755100,China;Dept.of Pathology,Ningxia Hui Autonomous Region People's Hospital,Yinchuan 750001,China;Ningxia Hui Autonomous Region Yinchuan Hospital of TCM,Yinchuan 750001,China)
出处 《中国药房》 CAS 北大核心 2019年第12期1707-1711,共5页 China Pharmacy
基金 宁夏青年科技人才托举工程.
关键词 替格瑞洛 氯吡格雷 急性冠脉综合征 疗效 安全性 META分析 Ticagrelor Clopidogrel Acute coronary syndrome Efficacy Safety Meta-analysis
作者简介 姚斌,主治医师,硕士。研究方向:中医内科学。电话:0951-5034753。E-mail:yinchuanlm@163.com;通信作者:雷鸣,副主任医师,博士。研究方向:中医学。电话:0951-5034753。E-mail:leiming1137@163.com.
  • 相关文献

参考文献29

二级参考文献276

  • 1张国明,王禹,陈练,盖鲁粤,杨庭树,孙志军,金琴花,王峙峰,计达.急性冠状动脉综合征患者急诊介入治疗临床研究[J].中华老年心脑血管病杂志,2007,9(3):159-162. 被引量:5
  • 2Hamm CW, Bassand JP, Agewall S, et al. ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation.- The Task Force for the management of acute coronary syndromes (ACS) in patients presenting without persistent ST-segment elevation of the European Society of Cardiology (ESC)[J]. Eur Heart J,2011,32(23) : 2999-3054. 被引量:1
  • 3Arora RR, Rai F. Antiplatelet intervention in acute coronary syndrome[J]. Am J Ther, 2009, 16 (5) : e29-e40. 被引量:1
  • 4Wiviott SD, Braunwald E, McCabe CH, et al. Pra- sugrel versus clopidogrel in patients with acute cor- onary syndromes[J]. N Engl J Med, 2007,357 (20) : 2001-2015. 被引量:1
  • 5Husted S, van Giezen JJ. Ticagrelor: the first re- versibly binding oral P2Y12 receptor antagonist [J]. Cardiovasc Ther,2009,27(4) : 259-274. 被引量:1
  • 6Wallentin L, Becker RC, Budaj A, et al. Ticagrelor versus clopidogrel in patients with acute coronary syndromes[J]. N Engl J Med,2009,361(11) : 1045- 1057. 被引量:1
  • 7Brilinta (ticagrelor) Tablets: A P2Y(12) platelet inhibitor indicated to reduce the rate of thromboticcardiovascular events in patients with acute coro- nary syndrome (ACS)[J]. P T, 2012,37(4 section 2) : 4-18. 被引量:1
  • 8Teng R, Butler K. Pharmacokinetics, pharmacody- namics, tolerability and safety of single ascending doses of ticagrelor, a reversibly binding oral P2Y (12) receptor antagonist, in healthy subjects[J]. Eur J Clin Pharmacol,2010,66(5) : 487-496. 被引量:1
  • 9Teng R, Oliver S, Hayes MA, et al. Absorption, distribution, metabolism, and excretion of ti- cagrelor in healthy subjects[J] Drug Metab Dispos, 2010,38(9) : 1514-1521. 被引量:1
  • 10Storey RF, Husted S, Harrington RA, et al. Inhi- bition of platelet aggregation by AZD6140, a re- versible oral P2Y12 receptor antagonist, compared with clopidogrel in patients with acute coronary syndromes[J]. J Am Coll Cardiol, 2007,50 (19) : 1852-1856. 被引量:1

共引文献203

投稿分析

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部 意见反馈