| 摘要: |
| 目的 比较不同抗凝强度的华法林对非瓣膜病心房颤动的安全性和疗效。方法 检索中国知网(CNKI)、万方数据库(Wanfang Data)、维普科技期刊(VIP)、PubMed、Cochrane Library、EMbase相关随机对照试验,采用 Review Manager 5.3软件进行 meta分析。结果 最终有14个临床试验纳入研究,共3 295例患者,其中国际标准化比值(INR)目标区间在1.5~2.0 (低抗凝强度组)1 403例, INR目标区间在2.0~3.0(标准抗凝强度组)1 892例。低抗凝强度组总出血发生率明显低于标准抗凝强度组(RR=0.47,95%CI:0.37~0.59,P<0.000 01);两组血栓栓塞发生率、缺血性脑卒中发生率、死亡率差异没有统计学意义(RR=1.35,95%CI:1.00~1.84,P=0.05;RR=1.44,95%CI:1.01~2.05,P=0.05;RR=1.06,95% CI:0.85~1.31,P=0.60)。结论 低强度华法林抗凝与标准强度相比可降低包括致命和严重出血在内的出血发生率,可能不会提高血栓栓塞发生率。 |
| 关键词: 华法林 非瓣膜病心房颤动 抗凝强度 meta分析 |
| DOI：10.16781/j.0258-879x.2016.02.0256 |
| 投稿时间：2015-07-10修订日期：2015-09-09 |
| 基金项目: |
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| Efficacy and safety of warfarin with different anticoagulation intensities in treatment of nonvalvular atrial fibrillation: meta-analysis |
| WANG Hang1,XU Xiao-gang2,HUANG Pin-fang1,WANG Chang-lian1* |
(1. Department of Pharmacy, The First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, Fujian, China;
2. Department of Pharmacy, Fujian Medical University, Fuzhou 350004, Fujian, China
*Corresponding author) |
| Abstract: |
| Objective To compare the efficacies and safety of warfarin with different anticoagulation intensities in treatment of nonvalvular atrial fibrillation. Methods Cochrane Library, EMbase, PubMed, Chinese Journal Full-text Database (CNKI), Wanfang Data and VIP Database (VIP) were searched by computer for randomized controlled trials of warfarin with different anticoagulation intensities in treatment of nonvalvular atrial fibrillation. The analysis was performed using the Review Manager 5.3. Results Finally a total of 14 literatures involving 3 295 participants were included. The results of meta-analysis showed the following:low anticoagulation intensity group (INR: 1.5-2.0, n=1 403) had a total bleeding rate significantly lower than the standard anticoagulation intensity group (INR: 2.0-3.0, n=1 892) (RR=0.47, 95%CI: 0.37-0.59, P<0.000 01); there were no significant differences in the incidence of thromboembolism (RR=1.35, 95%CI: 1.00-1.84, P=0.05), ischemic stroke (RR=1.44, 95%CI: 1.01-2.05, P=0.05) or mortality (RR=1.06, 95% CI: 0.85-1.31, P=0.60) between the two groups. Conclusion Warfarin therapy in international normalized ratio of 1.5-2.0 can reduce the risk of fatal and severe bleeding in patients with nonvalvular atrial fibrillation, and may not increase the incidence of thromboembolism. |
| Key words: warfarin nonvalvular atrial fibrillation anticoagulation intensity meta analysis |
