替格瑞洛与氯吡格雷用于急性冠状动脉综合征疗效及安全性比较的Meta分析  

Comparison of efficacy and safety of Ticagrelor versus Clopidogrel in patients with acute coronary syndrome by Meta-analysis

作　　者：何芸[1] 王淑香[1] 赵强[1] 吴同果[1] 

机构地区：[1]广州市红十字会医院心血管医学部,广州510220

出　　处：《白求恩医学杂志》2015年第4期354-356,共3页Journal of Bethune Medical Science

基　　金：广东省科技厅项目(2010B080702010)

摘　　要：目的应用Meta分析的方法评价急性冠状动脉综合征（ACS）患者使用替格瑞洛与氯吡格雷的疗效及安全性。方法计算机检索Cochrane临床对照试验中心注册库、Embase、PubMed、中国期刊全文数据库（CNKI）、中国生物医学文献数据库（CBM）及万方数据库，检索年限从建库到2014年12月。对符合质量标准的研究采用RevMan5．1进行异质性检验及Meta分析。最终入选5篇文献，20067例患者，其中氯吡格雷组9851例、替格瑞洛组10216例。以心血管死亡率比较评估疗效，以心肌梗死溶栓试验（TIMI）主要出血事件发生率比较评估安全性。结果与氯吡格雷组比较，替格瑞洛组患者心血管死亡率（RR=0．88，95％CI：0．82-0．95，Z=3．55，P=0．0004）显著降低，差别具有统计学意义；TIMI主要出血事件（RR=0．00，95％CI：-0．01-0．01，Z=0．57，P=0．57）的发生率相似。结论ACS患者应用替格瑞洛较氯吡格雷更能有效的降低心血管死亡率，且不增加TIMI主要出血风险。Objectives To investigate the efficacy and safety of ticagrelor versus clopidogrel in patients with acute coronary syndrome （ACS） by Meta-analysis. Methods The Cochranc central register of controlled trials, Embase, PubMed, China knowledge resource integrated database （CNKI）, China Biology Medicine （CBM） and Wanfang database were searched from the database estab- lishment to December of 2014. 5 references were selected for Meta-analysis by RevMan 5.1 software. 20067 patients were enrolled and divided into the clopidogrel group （ n=9851 ） and ticagrelor group （ n = 10216）. The efficacy was compared and evaluated with the mortality rate of cardio-vascular diseases. The safety was compared and evaluated with major bleeding complication rate of TIMI. Results The rate of death fi＇om cardio-vaseular diseases in the ticagrclor group （ RR = 0.88, 95 % CI ： 0.82 - O. 95, Z = 3.55, P = 0.0004） was lower than that of the clopidogrel group with significantly statistical difference, but there was no significant difference between the two groups in major bleeding rate （RR=0.00, 95%CI： -0.01 -0.01, Z =0.57, P =0.57）. Conclusion Ticagrelor is superior to clopidogrel for lowering the risk of death in patients with cardio-vascular diseases. Ticagrelor is not associated with a higher major bleeding rate in TIMI.

关 键 词：替格瑞洛 氯吡格雷 META分析 

分 类 号：R543.3[医药卫生—心血管疾病]