本文關(guān)鍵詞： 冠心病 雙抗血小板 藥物涂層支架 療程 隨機(jī)對(duì)照試驗(yàn) Meta分析　出處：《中國(guó)醫(yī)院藥學(xué)雜志》2017年10期 　論文類型：期刊論文

【摘要】：目的:系統(tǒng)評(píng)價(jià)不同冠心病患者藥物涂層支架置入術(shù)后雙抗血小板療程的有效性和安全性。方法:檢索MEDLINE、EMBASE和Cochrane Library數(shù)據(jù)庫(kù),獲得冠心病患者藥物涂層支架置入術(shù)后不同療程雙抗血小板治療的隨機(jī)對(duì)照試驗(yàn),采用RevMan 5.2軟件分別對(duì)性別、年齡、冠心病類型、是否合并糖尿病及置入不同藥物涂層支架患者短療程相對(duì)長(zhǎng)療程雙抗血小板治療的有效性和安全性進(jìn)行Meta分析。結(jié)果:共檢索到文獻(xiàn)4 322篇,最終納入9個(gè)隨機(jī)對(duì)照試驗(yàn),共30 244例患者。Meta分析顯示非老年患者[RR1.42,95%CI(1.20~1.70)]、置入紫杉醇[RR1.70,95%CI(1.26~2.29)]和西羅莫司藥物涂層支架[RR1.71,95%CI(1.07~2.74)]的患者短療程相對(duì)長(zhǎng)療程可增加未合并出血的主要復(fù)合終點(diǎn)發(fā)生率,而不同性別、老年患者、冠心病類型、是否合并糖尿病及置入依維莫司和佐他莫司藥物涂層支架的患者短療程相對(duì)長(zhǎng)療程雙抗血小板治療的主要復(fù)合終點(diǎn)發(fā)生率無(wú)顯著性差異。結(jié)論:臨床在為冠心病患者制定藥物涂層支架置入術(shù)后雙抗血小板療程時(shí)應(yīng)結(jié)合患者個(gè)體情況進(jìn)行綜合評(píng)估,對(duì)于非老年患者、置入紫杉醇和西羅莫司藥物涂層支架的患者可在指南推薦的基礎(chǔ)上適當(dāng)延長(zhǎng)雙抗血小板療程。
[Abstract]:Objective: to evaluate the efficacy and safety of double antiplatelet therapy in patients with different coronary heart disease after drug-coated stenting. Methods: MEDLINE EMBASE and Cochrane Library databases were searched. A randomized controlled trial of double antiplatelet therapy in different courses after drug-coated stenting was obtained in patients with coronary heart disease. Sex, age and type of coronary heart disease were determined by RevMan 5.2 software. Meta analysis was performed on the efficacy and safety of short-course, relatively long course double-antiplatelet therapy in patients with diabetes mellitus and different drug-coated stents. Results: a total of 4,322 articles were retrieved and included in 9 randomized controlled trials. A total of 30,244 patients. Meta-analysis showed that in non-elderly patients [RR1.42C95 CI1.201.70], paclitaxel [RR1.709CI1.262.29] and sirolimus drug-coated stents [RR1.71C95 CI1.072.74], short course of treatment and relatively long course of treatment increased the incidence of major complex endpoints without bleeding, whereas in elderly patients with different genders, Type of coronary heart disease, There was no significant difference in the incidence of major complex endpoints in patients with diabetes mellitus and patients with Evirolimus and zomolimus drug-coated stents. Conclusion: there is no significant difference in the incidence of major complex endpoints in patients with chronic coronary heart disease (CHD). Patients should make a comprehensive assessment of the course of treatment of double antiplatelet after drug-coated stent implantation according to the individual condition of the patient. For non-elderly patients, patients with paclitaxel and sirolimus drug-coated stents may extend the course of double-antiplatelet therapy appropriately on the basis recommended by the guidelines.
【作者單位】： 蘇州大學(xué)附屬第一醫(yī)院藥學(xué)部;
【基金】：國(guó)家自然科學(xué)基金資助項(xiàng)目(編號(hào):81173132) 江蘇省醫(yī)學(xué)重點(diǎn)人才資助項(xiàng)目(編號(hào):RC2011110) 蘇州市科技計(jì)劃項(xiàng)目(編號(hào):SYS2011137)
【分類號(hào)】：R541.4

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