【摘要】：目的對阿司匹林與氯吡格雷預(yù)防或治療缺血性腦卒中(IS)導(dǎo)致出血并發(fā)癥風(fēng)險(xiǎn)進(jìn)行評價(jià)。方法計(jì)算機(jī)檢索Pub Med、EMBase、The Cochrane Library、CBM、CNKI、VIP和Wang Fang Data等數(shù)據(jù)庫。檢索自建庫截止至2016年9月。搜集阿司匹林與氯吡格雷預(yù)防或治療IS且產(chǎn)生出血并發(fā)癥的隨機(jī)對照試驗(yàn)(RCT)。由2位研究人員獨(dú)立進(jìn)行文獻(xiàn)篩選、數(shù)據(jù)提取和質(zhì)量評價(jià)后,采用Rev Man 5.2軟件進(jìn)行Meta分析。結(jié)果共納入13個(gè)RCT,包括5204例患者。Meta分析結(jié)果顯示:(1)預(yù)防IS時(shí),阿司匹林相比氯吡格雷不增加皮膚黏膜、牙齦出血風(fēng)險(xiǎn),但增加消化道出血風(fēng)險(xiǎn);阿司匹林和氯吡格雷聯(lián)用相比阿司匹林單用增加胃腸道反應(yīng)。(2)治療IS時(shí),阿司匹林相比氯吡格雷不增加皮膚黏膜、牙齦、消化道出血風(fēng)險(xiǎn),不增加胃腸道反應(yīng);阿司匹林和氯吡格雷聯(lián)用相比阿司匹林單用亦不增加皮膚黏膜、牙齦、消化道、顱腦出血風(fēng)險(xiǎn),不增加胃腸道反應(yīng)。結(jié)論預(yù)防IS時(shí),阿司匹林相比氯吡格雷會(huì)增加消化道出血風(fēng)險(xiǎn),阿司匹林和氯吡格雷聯(lián)用相比阿司匹林單用會(huì)增加胃腸道反應(yīng)。
[Abstract]:Objective To evaluate the risk of hemorrhagic complications caused by the prevention or treatment of ischemic stroke (IS) by aspirin and chlordecay. Methods The databases of Pub Med, EMBase, The Cochrane Library, CBM, CNKI, VIP and Wang Fang Data were retrieved from the computer. The self-built library was retrieved until September 2016. A randomized controlled trial (RCT) for the prevention or treatment of IS and the occurrence of bleeding complications with aspirin and chloringray. Literature screening, data extraction and quality evaluation were carried out independently by two researchers, and Meta-analysis was carried out by using the Rev Man 5.2 software. Results A total of 13 RCTs were included, including 5204 patients. The results of the meta-analysis showed that: (1) In the prevention of IS, the risk of bleeding of the gingival bleeding was not increased compared with that of the chloringray, but the risk of the bleeding of the digestive tract was increased; and the combination of the aspirin and the chloroforgrel alone increased the gastrointestinal reaction. (2) In the treatment of IS, the risk of the skin mucosa, the gum, the digestive tract and the bleeding of the digestive tract is not increased as compared with the aspirin, and the gastrointestinal reaction is not increased; and the combination of the aspirin and the chlorhexidine gluconate does not increase the risk of the skin mucous membrane, the gum, the digestive tract and the head bleeding, The gastrointestinal reaction is not increased. Conclusion In the prevention of IS, aspirin may increase the risk of bleeding in the digestive tract, compared with the use of aspirin alone, and the use of aspirin alone will increase the gastrointestinal reaction.
【作者單位】： 克拉瑪依市中心醫(yī)院神經(jīng)內(nèi)科;克拉瑪依市中心醫(yī)院藥劑科;四川大學(xué)華西醫(yī)院循證醫(yī)學(xué)中心;
【基金】：克拉瑪依市科委立項(xiàng)項(xiàng)目(JK2014-18)
【分類號】：R743.3

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