摘要
目的比较冠状动脉粥样硬化性心脏病(冠心病)经皮冠状动脉介入治疗(PCI)术后吲哚布芬与阿司匹林抗栓治疗的有效性与安全性。方法计算机检索PubMed、The Cochrane Library、EMbase、中国知网、万方数据库,检索时间为建库至2023年1月,根据纳入与排除标准筛选文献并进行数据提取,采用RevMan 5.4软件进行分析。将纳入文献的研究对象分为试验组(吲哚布芬联合P2Y12受体拮抗剂)和对照组(阿司匹林联合P2Y12受体拮抗剂)。结局指标包括主要不良心血管事件(MACE)、出血事件、脑卒中及不良反应事件的发生率。结果共纳入16项随机对照试验,包含5893例研究对象,其中试验组2926例,对照组2967例。Meta分析结果显示,冠心病PCI术后应用吲哚布芬抗栓治疗与阿司匹林相比MACE、出血风险及不良反应事件的发生率均降低(MACE:RR=0.59,95%CI:0.43~0.80,P<0.01;出血事件:RR=0.55,95%CI:0.43~0.70,P<0.01;不良反应事件:RR=0.31,95%CI:0.20~0.47,P<0.01),脑卒中发生率两组无统计学差异(RR=0.75,95%CI:0.42~1.34,P>0.05)。结论冠心病PCI术后吲哚布芬联合P2Y12受体拮抗剂抗栓治疗的临床有效性与安全性均显示出了较好的优势,吲哚布芬可作为阿司匹林的替代药物。
Objective To compare the efficacy and safety of antithrombotic therapies between indobufen and aspirin in patients with coronary heart disease(CHD)after percutaneous coronary intervention(PCI).Methods The databases of PubMed,Cochrane Library,EMbase,CNKI and WanFang Data were retrieved with computer from database establishment time to Jan.2023.According to inclusion and exclusion criteria,all literature were screened,and data was extracted and analyzed by using RevMan 5.4 software.The subjects in included literature were divided into test group(indobufen combined with P2Y12 receptor antagonist)and control group(aspirin combined with P2Y12 receptor antagonist).The outcome indicators included the incidence of major adverse cardiovascular events(MACE),bleeding events,stroke and adverse events.Results There were totally 16 randomized controlled trials(RCT)included involved 5893 subjects,of them 2926 in test group and 2967 in control group.The Results of Meta-analysis showed that the incidence of MACE,bleeding risk and adverse events decreased after treatment with indobufen,compared with aspirin,in patients with CHD after PCI(MACE:RR=0.59,95%CI:0.43~0.80,P<0.01;bleeding events:RR=0.55,95%CI:0.43~0.70,P<0.01;adverse events:RR=0.31,95%CI:0.20~0.47,P<0.01).The incidence of stroke had no statistical significance between 2 groups(RR=0.75,95%CI:0.42-1.34,P>0.05).Conclusion The efficacy and safety of indobufen combined with P2Y12 receptor antagonist in antithrombotic treatment has a higher advantage in patients with CHD after PCI,and indobufen can be taken as an alternative drug for aspirin.
作者
段宇硕
普兆坤
王可
来利红
Duan Yushuo;Pu Zhaokun;Wang Ke;Lai Lihong(College of Clinical Medicine,Henan University of Science and Technology,Luoyang 471003,China;不详)
出处
《中国循证心血管医学杂志》
2024年第4期403-407,共5页
Chinese Journal of Evidence-Based Cardiovascular Medicine
基金
河南省洛阳市医疗卫生科研专项(2001029A)。
作者简介
通讯作者:来利红,E-mail:lailihongsuda@126.com。
