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应中央军委要求,2022年9月起,《药学实践杂志》将更名为《药学实践与服务》,双月刊,正文96页;2023年1月起,拟出版月刊,正文64页,数据库收录情况与原《药学实践杂志》相同。欢迎作者踊跃投稿!

植入药物洗脱支架后短期与长期双联抗血小板疗效比较的Meta分析

费舒扬 赵力 孙琳 张蓉 李晶 葛长江

费舒扬, 赵力, 孙琳, 张蓉, 李晶, 葛长江. 植入药物洗脱支架后短期与长期双联抗血小板疗效比较的Meta分析[J]. 药学实践与服务, 2020, 38(1): 81-87. doi: 10.3969/j.issn.1006-0111.201907135
引用本文: 费舒扬, 赵力, 孙琳, 张蓉, 李晶, 葛长江. 植入药物洗脱支架后短期与长期双联抗血小板疗效比较的Meta分析[J]. 药学实践与服务, 2020, 38(1): 81-87. doi: 10.3969/j.issn.1006-0111.201907135
FEI Shuyang, ZHAO Li, SUN Lin, ZHANG Rong, LI Jing, GE Changjiang. Comparison of short-term and long-term dual antiplatelet therapy after implantation of drug-eluting stents—Meta analysis[J]. Journal of Pharmaceutical Practice and Service, 2020, 38(1): 81-87. doi: 10.3969/j.issn.1006-0111.201907135
Citation: FEI Shuyang, ZHAO Li, SUN Lin, ZHANG Rong, LI Jing, GE Changjiang. Comparison of short-term and long-term dual antiplatelet therapy after implantation of drug-eluting stents—Meta analysis[J]. Journal of Pharmaceutical Practice and Service, 2020, 38(1): 81-87. doi: 10.3969/j.issn.1006-0111.201907135

植入药物洗脱支架后短期与长期双联抗血小板疗效比较的Meta分析

doi: 10.3969/j.issn.1006-0111.201907135

Comparison of short-term and long-term dual antiplatelet therapy after implantation of drug-eluting stents—Meta analysis

  • 摘要: 目的 评价短期(3~6个月)与长期(12个月)双联抗血小板治疗对冠状动脉药物洗脱支架植入后的临床效果。 方法 研究病例包括稳定性心绞痛、急性冠脉综合征、无症状心肌缺血,均为原位血管病变。临床观察终点为:全因死亡、心源性死亡、心肌梗死、卒中、支架内血栓形成、靶病变再血管化治疗、严重出血、净不良临床事件(net adverse clinical event)。通过检索Pubmed、中国生物医学文献等中、英文数据库及手工检索,对符合条件的随机对照研究经质量评估、数据提取,进行Meta分析。 结果 共计纳入12项随机对照研究。Detsky评分均大于5分。共计25 949个病例,随访率97.9%。两组在全因死亡(OR=0.86,95%CI 0.71~1.05,P=0.14)、心源性死亡(OR=0.94,95% CI 0.70~1.25,P=0.67)、支架血栓形成(OR=1.36,95%CI 0.94~1.98,P=0.11)、卒中(OR=1.01,95%CI 0.71~1.42,P=0.98)、靶病变再血管化(OR=0.121,95%CI 0.94~1.55,P=0.14)及净不良临床事件(OR=0.98,95%CI 0.83~1.14,P=0.75)均无明显差别;短期组随访期间心肌梗死发生率高于长期组(OR=1.27,95%CI 1.02~1.59,P=0.04),长期组严重出血的比例明显增加(OR=0.69,95%CI 0.50~0.95,P=0.02)。亚洲人群研究结果:长期治疗组全因死亡高于短期组(OR=0.72,95%CI 0.53~0.97,P=0.03),两组严重出血无明显差别。 结论 依据限定的临床观察终点,短期双联抗血小板疗效不劣于长期组;7项亚组人群研究,长期组全因死亡率高,不排除与样本量偏少产生的偏移及(或)人群的个体差异有关,结果还有待进一步验证。此结果可作为临床工作警示,依据患者出血风险及冠状动脉病变结果个体化调整双联抗血小板周期。
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植入药物洗脱支架后短期与长期双联抗血小板疗效比较的Meta分析

doi: 10.3969/j.issn.1006-0111.201907135

摘要: 目的 评价短期(3~6个月)与长期(12个月)双联抗血小板治疗对冠状动脉药物洗脱支架植入后的临床效果。 方法 研究病例包括稳定性心绞痛、急性冠脉综合征、无症状心肌缺血,均为原位血管病变。临床观察终点为:全因死亡、心源性死亡、心肌梗死、卒中、支架内血栓形成、靶病变再血管化治疗、严重出血、净不良临床事件(net adverse clinical event)。通过检索Pubmed、中国生物医学文献等中、英文数据库及手工检索,对符合条件的随机对照研究经质量评估、数据提取,进行Meta分析。 结果 共计纳入12项随机对照研究。Detsky评分均大于5分。共计25 949个病例,随访率97.9%。两组在全因死亡(OR=0.86,95%CI 0.71~1.05,P=0.14)、心源性死亡(OR=0.94,95% CI 0.70~1.25,P=0.67)、支架血栓形成(OR=1.36,95%CI 0.94~1.98,P=0.11)、卒中(OR=1.01,95%CI 0.71~1.42,P=0.98)、靶病变再血管化(OR=0.121,95%CI 0.94~1.55,P=0.14)及净不良临床事件(OR=0.98,95%CI 0.83~1.14,P=0.75)均无明显差别;短期组随访期间心肌梗死发生率高于长期组(OR=1.27,95%CI 1.02~1.59,P=0.04),长期组严重出血的比例明显增加(OR=0.69,95%CI 0.50~0.95,P=0.02)。亚洲人群研究结果:长期治疗组全因死亡高于短期组(OR=0.72,95%CI 0.53~0.97,P=0.03),两组严重出血无明显差别。 结论 依据限定的临床观察终点,短期双联抗血小板疗效不劣于长期组;7项亚组人群研究,长期组全因死亡率高,不排除与样本量偏少产生的偏移及(或)人群的个体差异有关,结果还有待进一步验证。此结果可作为临床工作警示,依据患者出血风险及冠状动脉病变结果个体化调整双联抗血小板周期。

English Abstract

费舒扬, 赵力, 孙琳, 张蓉, 李晶, 葛长江. 植入药物洗脱支架后短期与长期双联抗血小板疗效比较的Meta分析[J]. 药学实践与服务, 2020, 38(1): 81-87. doi: 10.3969/j.issn.1006-0111.201907135
引用本文: 费舒扬, 赵力, 孙琳, 张蓉, 李晶, 葛长江. 植入药物洗脱支架后短期与长期双联抗血小板疗效比较的Meta分析[J]. 药学实践与服务, 2020, 38(1): 81-87. doi: 10.3969/j.issn.1006-0111.201907135
FEI Shuyang, ZHAO Li, SUN Lin, ZHANG Rong, LI Jing, GE Changjiang. Comparison of short-term and long-term dual antiplatelet therapy after implantation of drug-eluting stents—Meta analysis[J]. Journal of Pharmaceutical Practice and Service, 2020, 38(1): 81-87. doi: 10.3969/j.issn.1006-0111.201907135
Citation: FEI Shuyang, ZHAO Li, SUN Lin, ZHANG Rong, LI Jing, GE Changjiang. Comparison of short-term and long-term dual antiplatelet therapy after implantation of drug-eluting stents—Meta analysis[J]. Journal of Pharmaceutical Practice and Service, 2020, 38(1): 81-87. doi: 10.3969/j.issn.1006-0111.201907135
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