留言板

尊敬的读者、作者、审稿人, 关于本刊的投稿、审稿、编辑和出版的任何问题, 您可以本页添加留言。我们将尽快给您答复。谢谢您的支持!

姓名
邮箱
手机号码
标题
留言内容
验证码
x 关闭 永久关闭

重要提示

《药学实践与服务》杂志不接收生物战剂、毒剂相关内容的稿件。对于涉军信息类论文如需投稿，请务必投稿前电话或邮箱咨询。联系电话：021-81871323，邮箱：yxsjzzs@163.com。敬请谅解，谢谢配合！

《药学实践与服务》编辑部

免责声明

《药学实践与服务》杂志目前不收取审稿费、版面费、加急费等费用，如收到邮件声称是编辑部X编辑，要求加作者微信的，请谨防财产损失！编辑部用于作者校稿时微信绑定的邮件是通过yxsjzzs@163.com发送的，标题是《药学实践与服务》XML数字出版服务微信绑定，请区分开！

7种新型口服抗凝药预防全髋、膝关节置换术后静脉血栓栓塞症的网状Meta分析

杨婕,  温华,  马冰,  孙晶

downloadPDF
文章导航 > 药学实践与服务  > 2018 >  36(6): 541-546
杨婕, 温华, 马冰, 孙晶. 7种新型口服抗凝药预防全髋、膝关节置换术后静脉血栓栓塞症的网状Meta分析[J]. 药学实践与服务, 2018, 36(6): 541-546. doi: 10.3969/j.issn.1006-0111.2018.06.014
引用本文: 杨婕, 温华, 马冰, 孙晶. 7种新型口服抗凝药预防全髋、膝关节置换术后静脉血栓栓塞症的网状Meta分析[J]. 药学实践与服务, 2018, 36(6): 541-546. doi: 10.3969/j.issn.1006-0111.2018.06.014
shu
YANG Jie, WEN Hua, MA Bing, SUN Jing. Seven kinds of new oral anticoagulants for prevention of venous thromboembolism after total hip or knee arthroplasty: a net Meta-analysis[J]. Journal of Pharmaceutical Practice and Service, 2018, 36(6): 541-546. doi: 10.3969/j.issn.1006-0111.2018.06.014
Citation: YANG Jie, WEN Hua, MA Bing, SUN Jing. Seven kinds of new oral anticoagulants for prevention of venous thromboembolism after total hip or knee arthroplasty: a net Meta-analysis[J]. Journal of Pharmaceutical Practice and Service, 2018, 36(6): 541-546. doi: 10.3969/j.issn.1006-0111.2018.06.014
shu

7种新型口服抗凝药预防全髋、膝关节置换术后静脉血栓栓塞症的网状Meta分析

doi: 10.3969/j.issn.1006-0111.2018.06.014
  • 1.

    中国医科大学附属第一医院呼吸科, 沈阳 110001

  • 2.

    中国医科大学附属第一医院流行病学教研室, 沈阳 110001

  • 3.

    解放军第463医院皮肤科, 沈阳 110042

Seven kinds of new oral anticoagulants for prevention of venous thromboembolism after total hip or knee arthroplasty: a net Meta-analysis

  • 1.

    Department of Pneumology, The First Hospital, China Medical University, Shenyang 110001, China

  • 2.

    Department of Epidemiology, The First Hospital, China Medical University, Shenyang 110001, China

  • 3.

    Department of Dermatology, No. 463 Hospital of PLA, Shengyang 110042, China

  • 摘要: 目的 采用网状Meta分析法，比较7种新型口服抗凝药预防全髋、膝关节置换术后静脉血栓栓塞症作用的有效性。 方法 检索CBM、Cochrane Library、Pubmed等数据库，从中提取随机对照试验，进行质量评价。应用软件Stata12.0，采用mvmeta程序包分析数据。 结果 检索相关文献1 091篇，24篇符合标准，共计40 001例患者；按处方药物用量评价预防静脉血栓栓塞症的有效性。直接比较结果：利伐沙班、阿哌沙班优于低分子肝素，结果分别为：RR=0.56，95% CI：0.40~0.78，P<0.05；RR=0.39，95% CI：0.24~0.63，P<0.05。其余5种新型口服抗凝药与低分子肝素比较无显著差别（P>0.05）。间接比较，结果均优于安慰剂。 结论 7种新型口服抗凝药预防全髋、膝关节置换术后静脉血栓栓塞症的有效性等级排名：阿哌沙班最佳，其次为利伐沙班、依度沙班、Ym150、TAK-442、达比加群酯、贝曲沙班。
    Abstract: Objective To assess the efficacy of seven kinds of new oral anticoagulants in prevention of venous thromboembolism in patients after total hip or knee replacement by a network Meta-analysis. Methods Randomized clinical trials in databases of CBM,Cochrane Library,Pubmed were searched. The quality of the included studies was assessed. Data were analyzed by Stata12.0 software,and mvmeta program package. Results 24 RCTs (in all 1 091 articles,40 001 patients) met the criteria. Prevention for VTE with prescribed dosage was evaluated. Following findings,directly,Rivaroxaban and Apixaban were more effective than low molecular weight heparin,results as (RR=0.56,95%CI:0.40-0.78),P<0.05;(RR=0.39,95%CI:0.24-0.63),P<0.05. The others compared with LMWH,P>0.05,had no statistical significance. Indirectly,these were all superior efficacy to placebo. Conclusion Grade rankings of efficacy for seven kinds of NOACs prevented VTE in patients after THR or TKR,Apixaban was best,followed by Rivaroxaban,Edoxaban,Ym150,TAK-442,dabigatran etexilate,Betrixaban.
  • [1] 吴丹辰,贾镭,徐希奇,等.新型口服抗凝药物预防及治疗静脉血栓栓塞症研究进展[J].中华关节外科杂志[J/OL],2013,7(3):420.
    [2] 邱贵兴.中国骨科大手术静脉血栓栓塞症预防指南[J].中华关节外科杂志[J/OL],2009,3(3):380.
    [3] 张超,陶华,李胜,等.应用Stata软件mvmeta程序包实现网状Meta分析[J].Chin J Evid-based Med,2014,14(9):1150-1159.
    [4] ERIKSSON B,DNHL OE,ROSENEHER N,et al.Dabigatran etexilate for prevention of venous thromboembolism after total hip replacement a randomised double-blin non-inferiority trial[J].Lancet,2007,370(9591):949-956.
    [5] ERIKSSON BI,DAHL OE,HUO MH,et al.Oral dabigatran versus enoxaparin for thromboprophylaxis after primary total hip arthroplasty[J].Thromb Haemost,2011,105(4):721-729.
    [6] ERIKSSON B,DNHL OE,ROEENCHER N,et al.Oral dabigatran etexilate and subctltalleous enoxparin for the prevention of veneous thromboembolism after total knee replacement the RE-MODEL randomized trial[J].J Thromb Haemost,2007,5(11):2178-2185.
    [7] GINSBERG JS,DAVIDSON BL,COMP PC,et al.Oral thrombin inhibitor or dabigatan etexilate and North Ameriean enoxaparin regimen for prevention of venous thrombomembolism after knee arthroplasty surgery[J].J Arthroplasty,2009,24(1):1-9.
    [8] ERIKSSON BI,BORRIS LC,FRIEDMAN RJ,et al.Rivaroxaban versus enoxaparin for thromboprophylaxis after hip arthroplasty[J].N Engl J Med,2008,358(26):2765-2775.
    [9] KAKKAR AK,BRENNER B,DAHL OE,et al.Extended duration rivaroxaban versus short-term enoxaparin for the prevention of venous thromboembolism after total hip arthroplasty:a double-blind,randomised controlled trial[J].Lancet,2008,372(9632):31-39.
    [10] LASSEN MR,AGENO W,BORRIS LC,et al.Rivaroxaban versus enoxaparin for thromboprophylaxis after total knee arthroplasty[J].N Engl J Med,2008,358(26):2776-2786.
    [11] TURPIE AG,LASSEN MR,DAVIDSON BL,et al.Rivaroxaban versus enoxaparin for thromboprophylaxis after total knee arthroplasty (RECORD4) a randomised trial[J].Lancet,2009,373(9676):1673-1680.
    [12] ERIKSSON BI,BORRIS L,DAHL OE,et al.For the ODIXa-HIP investigators study a randomised trial:a once-daily oral direct factor Xa inhibitor rivaroxaban (BAY 59-7939) for thromboprophylaxis after total hip replacement[J]. Circulation,2006,114(22):2374-2381.
    [13] ERIKSSON BI,BORRIS L,DAHL OE,et al.For the ODIXa-HIP investigators study a randomised trial:oral direct factor Xa inhibition with BAY 59-7939 for the prevention of venous thromboembolism after total hip replacement[J]. Thromb Haemost,2006,4:121-128.
    [14] TURPIE, FISHER, BAUER,et al.BAY 59-7939 an oral direct factor Xa inhibitor for the prevention of venous thromboembolism in patients after total knee replacement a phase Ⅱ dose-ranging study[J].Thromb Haemost,2005,3(11):2479-2486.
    [15] ERIKSSON BI,BORRIS LC,DAHL OE,et al.Dose-escalation study of rivaroxaban(BAY 59-7939) an oral direct factor Xa inhibitor-for the prevention of venous thromboembolism in patients undergoing total hip replacement[J].Thromb Res,2007,120(5):685-693.
    [16] LASSEN MR,DAVIDSON BL,GALLUS A,et al.The efficacy and safety of apixaban an oral direct factor Xa inhibitor as thromboprophylaxis in patients following total knee replacement[J].J Thromb Haemost,2007,5(12):2368-2375.
    [17] LASSEN MR,RASKOB GE,GALLUS A,et al.Apixaban or enoxaparin for thromboprophylaxis after knee replacement[J].N Engl J Med,2009,361(6):594-604.
    [18] LASSEN MR,RASKOB GE,GALLUS A,et al.Apixaban versus enoxaparin for thromboprophylaxis after knee replacement a randomised double-blind trial[J].Lancet,2010,375(9717):807-815.
    [19] LASSEN MR,GALLUS A,RASKOB GE,et al.Apixaban versus enoxaparin for thromboprophylaxis after hip replacement[J].N Engl J Med,2010,363(26):2487-2498.
    [20] FUJI T,FUJITA S,TACHIBANA S,et al.A dose-ranging study evaluating the oral factor Ⅹa inhibitor edoxaban for the prevention of venous thromboembolism in patients undergoing total knee arthroplasty[J].J Thromb Haemost,2010,8(11):2458-2468.
    [21] FUJI T,FUJITA S,KAWAI Y,et al.Efficacy and safety of edoxaban versus enoxaparin for the prevention of venous thromboembolism following total hip arthroplasty:STARS J-V[J].Thromb J,2015,13:27.
    [22] RASKOB G,COHEN AT,ERIKSSON BI,et al.Oral direct factor Xa inhibition with edoxaban for thromboprophylaxis after elective total hip replacement.a randomised double-blind dose-response study[J].Thromb Haemost,2010,104(3):642-649.
    [23] TURPIE AG,BAUER KA,DAVIDSON BL,et al. A randomized evaluation of betrixaban an oral factor Xa inhibitor for prevention of thromboembolic events after total knee replacement[J].Thromb Haemost,2009,101(1):68-76.
    [24] WEITZ JI,CAO C,ERIKSSON BI,et al.A dose-finding study with TAK-442 an oral factor Xa inhibitor in patients undergoing elective total knee replacement surgery[J].Thromb Haemost,2010,104(6):1150-1157.
    [25] ERIKSSON BI,TURPIE AG,LASSEN MR,et al.Prevention of venous thromboembolism with an oral factor Xa inhibitor YM150 after total hip arthroplasty a dose finding study (ONYX-2)[J].Journal of Thrombosis and Haemostasis,2010,8:714-721.
    [26] FUJI T,NAKAMURA M,TAKEUCHI M.Darexaban for the prevention of venous thromboembolism in Asian patients undergoing orthopedic surgery results from 2 randomized placebo-controlled,double-blind studies[J].Clinical and Applied Thrombosis Hemostasis,2014,20(2):199-211.
    [27] ERIKSSON BI,AGNELLI G,GALLUS AS,et al.Darexaban (YM150) versus enoxaparin for the prevention of venous thromboembolism after total hip arthroplasty a randomised phase Ⅱb dose confirmation study (ONYX-3)[J].Thromb Haemost,2014,111(2):213-225.
    [28] STEVENSON M,SCOPE A,HOLMES M,et al.Rivaroxaban for the prevention of venous thromboembolism a single technology appraisal[J].Health Technol Assess,2009,13:43-48.
    [29] GOMEZ-OUTESA,TERLEIRA-FERNANDEZ AI,SUAREZ-GEA ML,et al.Dabigatran rivaroxaban or apixaban versus enoxaparin for thromboprophylaxis after total hip or knee replacement systematic review meta-analysis,and indirect treatment comparisons[J].BMJ,2012,344(14):3675.
  • [1] 陈明, 王晨佳, 唐原君, 汪硕闻, 范国荣.  新型靶向抗肿瘤药物呋喹替尼的治疗药物监测方法构建及其临床应用 . 药学实践与服务, 2025, 43(12): 1-4. doi: 10.12206/j.issn.2097-2024.202412043
    [2] 施乔, 韩贵焱, 张俊腾, 刘娜.  新型Hsp90抑制剂的设计合成及其抗真菌和抗肿瘤活性研究 . 药学实践与服务, 2025, 43(3): 124-135. doi: 10.12206/j.issn.2097-2024.202501019
    [3] 吴若南, 叶爽, 李墨晨轩, 缪震元, 罗川.  冬凌草甲素磺酰脲衍生物的设计与抗炎活性研究 . 药学实践与服务, 2025, 43(7): 335-338, 352. doi: 10.12206/j.issn.2097-2024.202401048
    [4] 陶宫佳, 陈林林, 宋泽成, 刘梦肖, 王彦.  苦参碱及衍生物的抗炎作用及其机制研究进展 . 药学实践与服务, 2025, 43(4): 163-168, 194. doi: 10.12206/j.issn.2097-2024.202406035
    [5] 宋泽成, 马闪闪, 胡巧灵, 仲华, 王彦.  小檗碱与氟康唑合用抗氟康唑耐受白念珠菌的研究 . 药学实践与服务, 2025, 43(2): 87-91. doi: 10.12206/j.issn.2097-2024.202409047
    [6] 刘琳琳, 钟桂香, 严佳, 周欣.  不同使用条件下固相萃取柱对复方甘草口服溶液吗啡含量测定的影响 . 药学实践与服务, 2025, 43(12): 598-601. doi: 10.12206/j.issn.2097-2024.202311012
    [7] 刘安泽, 何盈盈, 王欢, 鲁莹.  基于天然IgM新型佐剂的叶酸脂质体疫苗制备及评价 . 药学实践与服务, 2025, 43(11): 555-559. doi: 10.12206/j.issn.2097-2024.202401060
    [8] 卢熠菲, 宋佳, 沈红霞, 赵庆杰.  新型苦参碱衍生物的设计合成与体外抗炎活性研究 . 药学实践与服务, 2025, 43(): 1-8. doi: 10.12206/j.issn.2097-2024.202503005
    [9] 黄欣, 杨茹洁, 秦峰, 张士莲, 吴莘, 尹小燕.  硫酸镁钠钾口服液在内镜肠道清洁准备中的效果 . 药学实践与服务, 2025, 43(): 1-4. doi: 10.12206/j.issn.2097-2024.202311049
    [10] 关梦瑶, 夏天爽, 何旭辉, 史策, 蒋益萍, 辛海量.  黑蒜多糖抗便秘作用研究 . 药学实践与服务, 2025, 43(4): 190-194. doi: 10.12206/j.issn.2097-2024.202403059
    [11] 詹济华, 颜滢.  低蛋白血症对头孢哌酮舒巴坦血药浓度的影响 . 药学实践与服务, 2025, 43(7): 344-347. doi: 10.12206/j.issn.2097-2024.202309040
    [12] 张霖峰, 孙宇恒, 王冬尧, 李丹, 曹岩, 吕狄亚.  茵陈蒿汤体内成分分析及其抗肝癌作用机制的网络药理学研究 . 药学实践与服务, 2025, 43(): 1-9. doi: 10.12206/j.issn.2097-2024.202501017
    [13] 钟玲, 曹金发, 何苗, 田泾.  晚期胃癌患者紫杉醇脂质体简化口服预处理方案的实践及分析 . 药学实践与服务, 2025, 43(): 1-4. doi: 10.12206/j.issn.2097-2024.202406047
    [14] 邱彦, 吴浩, 董雅芬, 陈业, 王建, 金辉.  新型二氢卟吩化合物的光动力性能及其抗肺癌作用研究 . 药学实践与服务, 2025, 43(): 1-7. doi: 10.12206/j.issn.2097-2024.202304011
    [15] 魏雨辰, 田家盛, 王道鑫, 凌期盛, 王治, 缪朝玉.  烟酰胺单核苷酸口服给药对高血压大鼠的影响 . 药学实践与服务, 2025, 43(5): 213-221. doi: 10.12206/j.issn.2097-2024.202412006
    [16] 陈婷如, 顾秦五风, 吴芸杨, 孟园园, 杨延龙, 李睿旻.  中药外治法治疗湿疹引起皮肤瘙痒的Meta分析 . 药学实践与服务, 2025, 43(8): 383-389. doi: 10.12206/j.issn.2097-2024.202504013
    [17] 韦薇, 张明霞, 周艳萍, 颜岚, 田鹏, 冯霞.  基于失效模式与效应分析优化静脉用药调配中心全流程质量控制体系 . 药学实践与服务, 2025, 43(): 1-7. doi: 10.12206/j.issn.2097-2024.202504131
    [18] 陈官旭, 宋雨桐, 郭秀强, 张咪, 刘志宏, 宋洪涛.  EGFR-TKIs单药及其联合方案在晚期非小细胞肺癌一线治疗中的疗效与安全性比较：网状Meta分析 . 药学实践与服务, 2025, 43(): 1-11. doi: 10.12206/j.issn.2097-2024.202504044
    [19] 张艺昕, 关欣怡, 王博宁, 闻俊, 洪战英.  二氢吡啶类钙离子拮抗药物手性分析及其立体选择性药动学研究进展 . 药学实践与服务, 2024, 42(8): 319-324. doi: 10.12206/j.issn.2097-2024.202308062
    [20] 刘丽艳, 余小翠, 孙传铎.  纳武利尤单抗治疗非小细胞肺癌有效性及安全性的Meta分析 . 药学实践与服务, 2024, 42(10): 451-456. doi: 10.12206/j.issn.2097-2024.202310044
  • 加载中
WeChat 点击查看大图
计量
  • 文章访问数:  4642
  • HTML全文浏览量:  588
  • PDF下载量:  487
  • 被引次数: 0
出版历程
  • 收稿日期:  2017-12-01
  • 修回日期:  2018-08-25

7种新型口服抗凝药预防全髋、膝关节置换术后静脉血栓栓塞症的网状Meta分析

doi: 10.3969/j.issn.1006-0111.2018.06.014
  • 1. 中国医科大学附属第一医院呼吸科, 沈阳 110001
  • 2. 中国医科大学附属第一医院流行病学教研室, 沈阳 110001
  • 3. 解放军第463医院皮肤科, 沈阳 110042
  • 收稿日期: 2017-12-01
  • 修回日期: 2018-08-25

摘要: 目的 采用网状Meta分析法，比较7种新型口服抗凝药预防全髋、膝关节置换术后静脉血栓栓塞症作用的有效性。 方法 检索CBM、Cochrane Library、Pubmed等数据库，从中提取随机对照试验，进行质量评价。应用软件Stata12.0，采用mvmeta程序包分析数据。 结果 检索相关文献1 091篇，24篇符合标准，共计40 001例患者；按处方药物用量评价预防静脉血栓栓塞症的有效性。直接比较结果：利伐沙班、阿哌沙班优于低分子肝素，结果分别为：RR=0.56，95% CI：0.40~0.78，P<0.05；RR=0.39，95% CI：0.24~0.63，P<0.05。其余5种新型口服抗凝药与低分子肝素比较无显著差别（P>0.05）。间接比较，结果均优于安慰剂。 结论 7种新型口服抗凝药预防全髋、膝关节置换术后静脉血栓栓塞症的有效性等级排名：阿哌沙班最佳，其次为利伐沙班、依度沙班、Ym150、TAK-442、达比加群酯、贝曲沙班。

English Abstract

杨婕, 温华, 马冰, 孙晶. 7种新型口服抗凝药预防全髋、膝关节置换术后静脉血栓栓塞症的网状Meta分析[J]. 药学实践与服务, 2018, 36(6): 541-546. doi: 10.3969/j.issn.1006-0111.2018.06.014
引用本文: 杨婕, 温华, 马冰, 孙晶. 7种新型口服抗凝药预防全髋、膝关节置换术后静脉血栓栓塞症的网状Meta分析[J]. 药学实践与服务, 2018, 36(6): 541-546. doi: 10.3969/j.issn.1006-0111.2018.06.014
shu
YANG Jie, WEN Hua, MA Bing, SUN Jing. Seven kinds of new oral anticoagulants for prevention of venous thromboembolism after total hip or knee arthroplasty: a net Meta-analysis[J]. Journal of Pharmaceutical Practice and Service, 2018, 36(6): 541-546. doi: 10.3969/j.issn.1006-0111.2018.06.014
Citation: YANG Jie, WEN Hua, MA Bing, SUN Jing. Seven kinds of new oral anticoagulants for prevention of venous thromboembolism after total hip or knee arthroplasty: a net Meta-analysis[J]. Journal of Pharmaceutical Practice and Service, 2018, 36(6): 541-546. doi: 10.3969/j.issn.1006-0111.2018.06.014
shu

    全文HTML

参考文献 (29)

目录

    /

    返回文章
    返回

    版权所有：《药学实践与服务》编辑委员会

    主管、主办: 中国人民解放军海军军医大学地址: 上海市杨浦区国和路325号邮政编码: 200433

    电话: （021）81871324,81871397 E-mail: yxsjzzs@163.com

    网站备案号 沪ICP备05003363号-1

    本系统由 北京仁和汇智信息技术有限公司 开发    百度统计