阿司匹林预防结直肠腺瘤的Meta分析  

Aspirin for the chemoprevention of colorectal adenomas:a Meta-analysis

作　　者：狄连君[1] 陈有享[1] 赵逵[1] 李红平[1] 闫兆平[1] 

机构地区：[1]遵义医学院附属医院消化内科,贵州遵义563003

出　　处：《重庆医学》2011年第19期1889-1891,共3页Chongqing medicine

基　　金：贵州省科技计划基金资助项目[黔省科合S字(2007)1031]

摘　　要：目的系统性评价阿司匹林预防结直肠腺瘤的有效性和安全性。方法结合所有随机双盲安慰剂数据对照试验来评价阿司匹林对结直肠腺瘤的预防作用,检索Medline(1966年1月至2009年1月)数据库,OVID(1996年1月至2009年1月)数据库,Embase(1980年1月至2009年1月)数据库,中国生物医学文献数据库(CBMdisk,1996年1月至2009年1月),并鉴定随机对照研究(RCT)的质量。按Jadad质量评分进行评定。用Rev Man 4.2软件进行荟萃分析。结果共有5篇文献,其中4篇为随机临床对照试验,1篇为队列研究;共有24 770例纳入研究,任何剂量阿司匹林与安慰剂比较,预防结直肠腺瘤的发生,P=0.002,PetoOR=0.82,95%CI=0.72～0.93;高剂量阿司匹林和安慰组比较,P=0.006,PetoOR=0.78,95%CI=0.65～0.93;小剂量阿司匹林和安慰组比较P=0.05,PetoOR=0.85,95%CI=0.72～1.00;各剂量阿司匹林组均可预防结直肠腺瘤的发生;发生不良反应事件的危险度各剂量阿司匹林组间比较差异无统计学意义,但中风的发生率高于安慰剂组。结论阿司匹林剂可以有效消退结直肠腺瘤性息肉,但其潜在的风险,尚不可作为常规用药,还需临床研究进一步确定在特殊人群中预防性使用非甾体类抗炎药(NSAIDs)的最佳剂量和疗程。Objective To determine the validity and safety of the Asprin for the prevention of colorectal adenomas.Methods We combined data of all randomized double-blind,placebo-controlled trial to assess aspirin on colorectal adenoma prevention role,search Medline（1966 to January 2009）database,OVID（1996 to January 2009）database,Embase（1980 to January 2009）databases,the Chinese Biomedical Literature Database（CBMdisk,1996 to January 2009）,quality of randomized controlled trials（RCT）was assessed by Jadad quality score,Rev Man 4.2 software was used for meta-analysis.Results Five sdudies（four randomized clinical controlled trials,one cohort）were identified,a total of 24.77 thousand cases included in the study.Any dose of aspirin compared with placebo group（P=0.002,Peto OR=0.82,95% CI：0.72-0.9）;high-dose aspirin compared with placebo group（P=0.006,Peto OR=0.78,95% CI：0.65-0.93）;low-dose aspirin compared with placebo group（P=0.05,Peto OR=0.85,95% CI：0.72-1.00）,all could prevent the occurrence of colorectal adenomas.Except the occurrence of stroke was higher in any dose of aspirin compared with placebo group（P=0.00）,the risks of adverse reactions were no significant difference in all groups.Conclusion Aspirin can prevent the occurrence of colorectal adenomas.However,because of its potential risks,it is not used as conventional medicine.There are clinical trials need to further define the optimal dose and duration of treatment of the prophylactic use of Asprin.

关 键 词：阿司匹林 腺瘤 结肠肿瘤 直肠肿瘤 非甾体类消炎药 荟萃分析 

分 类 号：R735.3[医药卫生—肿瘤]