血液透析患者阿司匹林出血事件的meta分析  

Aspirin in hemodialysis patients:a meta analysis of bleeding events

作　　者：聂晟[1] 谢迪[1] 李璐[2] 梁敏[1] 

机构地区：[1]南方医科大学南方医院肾脏病科,广州510515 [2]南方医科大学第一临床医学院,广州510515

出　　处：《郑州大学学报（医学版）》2013年第1期35-38,共4页Journal of Zhengzhou University(Medical Sciences)

基　　金：国家自然科学基金面上项目30971382

摘　　要：目的:明确阿司匹林在血液透析患者中应用的出血风险。方法:检索数据库Medline、Cochrane图书馆、维普数据库、中国期刊全文数据库、中国生物医学文献数据库。纳入关于阿司匹林在血液透析患者中应用的所有前瞻性临床随机对照试验,评价文献质量,并提取符合纳入标准的数据,采用RevMan4.2进行meta分析。结果:纳入10项临床随机对照试验,共686例患者,有44例发生出血事件,其中治疗组20例,对照组24例,OR(95%CI)=0.90(0.47～1.72),P=0.74,组间差异无统计学意义。纳入患者中有104例发生透析血管通路血栓事件,其中治疗组39例,对照组65例,OR(95%CI)=0.37(0.16～0.84),P=0.02,组间差异有统计学意义。结论:未发现阿司匹林增加血液透析患者的出血风险,同时阿司匹林能降低血液透析患者血管通路血栓形成的风险。Aim：To identify the risk of bleeding in hemodialysis patients with aspirin.Methods：Prospective randomized controlled trails（RCT） of aspirin in the hemodialysis patients were selected from database such as Medline,Cochrane Controlled Trials Register,VIP Database,CNKI,CBM.Quality of the RCTs was evaluated,and the data met the inclusion criteria were extracted.Review Manager Software 4.2 was used for statistical analysis.Results：Ten trials with a total of 686 participants were included.The meta analysis showed bleeding events occurred in 44 patients,20 in aspirin group,24 in control group.There was no significant difference between the two groups in bleeding events（OR=0.90,95%CI=0.47~1.72,P=0.74）.Otherwise,there were 104 patients with thrombosis events reported in eight trials.The meta analysis showed aspirin significantly reduced the risk of thrombosis events in hemodialysis vascular access（OR=0.37,95%CI=0.16~0.84,P=0.02）.Conclusion：Aspirin may not increase the risk of bleeding in hemodialysis patients,but reduce the risk of thrombosis in vascular access.

关 键 词：阿司匹林 血液透析 出血事件 META分析 

分 类 号：R459.5[医药卫生—治疗学]