华法林对房颤患者抗凝治疗效果及安全性的Meta分析.docVIP

华法林对房颤患者抗凝治疗效果及安全性的Meta分析 　　[摘要] 目的 用Meta分析的方法评价华法林对房颤患者抗凝治疗的效果及安全性。 方法 收集已公开发表的有关华法林对房颤患者抗凝治疗的随机或临床对照试验方面的文献，按Meta分析的要求对检索到的原始研究进行质量评估，采用RevMan 5.1对符合条件的研究进行Meta分析，评价华法林对房颤患者的抗凝效果及安全性。 结果 符合纳入标准的文献共13篇（中文9篇，英文4篇），总样本量为4985例。华法林组的抗凝效果优于阿司匹林或未予抗凝治疗组[OR = 0.28，95%CI（0.22～0.35），P 0.001]，华法林组与阿司匹林或未予抗凝治疗组不良反应（全身出血）发生率差异无统计学意义[OR = 1.40，95%CI（0.96～2.04），P = 0.08]。 结论 在适当剂量范围内，华法林的安全性与阿司匹林或未予抗凝治疗的无明显差异，但前者的抗凝效果更佳。 　　[关键词] 华法林；房颤；抗凝；安全性；Meta分析 　　[中图分类号] R541.75 [文献标识码] A [文章编号] 1673-7210（2013）11（c）-0101-03 　　Meta analysis of Warfarins anticoagulant effectiveness and safety in patients with atrial fibrillation 　　LIU Menglin WAN Jun WANG Menglong 　　Department of Cardiology， Renmin Hospital of Wuhan University， Hubei Province， Wuhan 430000， China 　　[Abstract] Objective To evaluate anticoagulant effectiveness and safety of Warfarin in patients with atrial fibrillation. Methods Articles of randomized controlled trials or clinical controlled trial which had been published and on Warfarins anticoagulant therapy in patients with atrial fibrillation were searched， and the requirements of Meta analysis were used to evaluate the quality of original researches. And then RevMan 5.1 was used to make Meta analysis of eligible studies and evaluate anticoagulant effectiveness and safety of Warfarin in patients with atrial fibrillation. Results There were 13 articles meet inclusion criteria （nine of Chinese， four of English） and the total sample size was 4985. The anticoagulant effectiveness of Warfarin was better than that of Aspirin or unanticoagulant [OR = 0.28， 95%CI （0.22-0.35）， P 0.001]， and there was no significant difference of safety between them [OR = 1.40， 95%CI （0.96-2.04）， P = 0.08]. Conclusion Within the scope of the appropriate dosage， the safety of Warfarin and Aspirin or unanticoagulant is equal， but the anticoagulant effectiveness of former is better. 　　[Key words] Warfarin； Atrial fibrillation； Anticoagulant； Safety； Meta analysis 　　2012年有关预防房颤的血栓形成指南指出房颤是最常