中国全科医学2017，Vol.20Issue(11)：1341-1347,7.DOI:10.3969/j.issn.1007-9572.2017.11.013
新型口服抗凝药对我国非瓣膜性心房颤动患者治疗效果与安全性的Meta分析
Efficacy and Safety of New Oral Anticoagulants in the Treatment of Patients with Non-valvular Atrial Fibrillation in China: a Meta-analysis
摘要
Abstract
Background Non-valvular atrial fibrillation (NVAF) is a common clinical arrhythmia,which often causes embolic events,so the anticoagulant therapy is particularly important in the treatment of atrial fibrillation.Warfarin has been proved to be effective traditional oral anticoagulants,but has been limited in clinical because of the shortcomings as high risk of bleeding.Recently,the emergence of new oral anticoagulants (NOACs) overcomes the drawback of warfarin and gets much clinical attention.Objective To evaluate the efficacy and safety of NOACs in the treatment of domestic patients with NVAF.Methods From September 2015 to August 2016,the related randomized controlled trials (RCT) of NOACs and warfarin in the treatment of NVAF were selected from Cochrane Library,PubMed,Web of Science,EMBase,CNKI,CBM,VIP and Wanfang Data Knowledge Service Platform through computer retrieval.Extract the relevant information from the literature,and evaluate the quality of the literature.Results 15 literatures and a total of 2 246 patients were included,the quality score of the literatures were from 4 to 5.Meta analysis showed that compared with warfarin,NOACs can reduce the incidence of stroke [OR =0.65,95％CI (0.43,0.97),P=0.04],non-major bleeding [OR=0.44,95％CI (0.31,0.61),P＜0.001],and major bleeding [OR =0.45,95％ CI (0.22,0.91),P =0.03] of patients with NVAF.However,no significant differences were found in the incidence of non central nervous system thromboembolism [OR =0.72,95％ CI (0.46,1.14),P =0.16].Conclusion The incidence of stroke,non-major bleeding and major bleeding of patients using NOACs is lower than that of patients using warfarin,and no difference in the incidence of non central nervous system of patients using NOACs or warfarin.The efficacy and safety of NOACs is good in the treatment of domestic patients with NVAF.关键词
心房颤动/新型口服抗凝药/华法林/栓塞/出血/Meta分析Key words
Atrial fibrillation/New oral anticoagulants/Warfarin/Embolism/Hemorrhage/Meta-analysis分类
医药卫生引用本文复制引用
颜建龙,赛音夫,LAM HOANG TRUC,邵文明,谭国强,张爱东..新型口服抗凝药对我国非瓣膜性心房颤动患者治疗效果与安全性的Meta分析[J].中国全科医学,2017,20(11):1341-1347,7.基金项目
广州市天河区2015年度科技计划项目(201504KW021) （201504KW021）
