原发性免疫性血小板减少症患者抗磷脂抗体与血栓形成相关风险性的Meta分析  

Association between antiphospholipid antibodies and the risk of thrombosis in patients with primary immune thrombocytopenia:A Meta-analysis

作　　者：葛星瑶 张超[2] 鄢金柱 原瑞霞 王伟[5] Ge Xingyao;Zhang Chao;Yan Jinzhu;Yuan Ruixia;Wang Wei(Department of First Clinical Medical College, Beihua University, Jilin 132000, China)

机构地区：[1]北华大学第一临床医学院,吉林132000 [2]十堰市太和医院(湖北医药学院附属医院)循证医学中心,十堰442000 [3]石河子大学医学院第一附属医院肝胆外科,石河子832000 [4]武汉大学公共卫生学院,武汉430000 [5]北华大学附属医院血液内科,吉林132000

出　　处：《中国循证心血管医学杂志》2017年第7期788-791,共4页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的系统评价原发性免疫性血小板减少症(ITP)患者抗磷脂抗体与血栓形成的相关风险性。方法计算机检索Pub Med、EMbase、The Cochrane Library、CBM、CNKI、VIP和Wan Fang Data,并手工检索相关期刊,全面收集原发性免疫性血小板减少症患者抗磷脂抗体与血栓形成相关风险性的相关队列研究,检索时限均为建库至2016年8月。由2位评价员按照纳入与排除标准独立筛选文献、提取资料和评价纳入研究的偏倚风险后,采用Rev Man 5.3软件进行Meta分析。结果共纳入10篇文献,共1574例患者。Meta分析结果显示:狼疮抗凝物(LA)阴性患者比LA阳性患者血栓发生率低,其差异有统计学意义(OR=6.35,95%CI:3.53~11.42,P<0.00001);抗心凝脂(aCL)阴性患者比aCL阳性患者血栓发生率低,其差异有统计学意义(OR=2.79,95%CI:1.50~5.18,P=0.001)。结论 ITP患者LA及aCL阳性可能是血栓形成的高危因素。Objective To systematically review the association between antiphospholipid antibodies and therisk of thrombosis in patients with primary immune thrombocytopenia(ITP).Methods We electronically searcheddatabases including PubMed,EMbase,the Cochrane Library,CBM,CNKI,VIP,WanFang Data to collect cohortstudies about the association between antiphospholipid antibodies and the risk of thrombosis in patients withprimary immune thrombocytopenia from inception to April,2016.Two reviewers screened literature according to theinclusion and exclusion criteria,extracted data,and assessed the quality of included studies.RevMan5.3were usedto conduct the meta-analysis.Results A total of ten studies involving1574patients were included.The results ofmeta-analysis indicated that,the incidence of thrombosis was significantly lower in the lupus anticoagulant(LA)negative patients(OR=6.35,95%CI:3.53~11.42,P<0.00001).The incidence of thrombosis was also significantlylower in anticardiolipin(aCL)negative patients(OR=2.79,95%CI:1.50~5.18,P=0.001).Conclusion LA and aCLpositivity are associated with an enhanced risk of thrombosis in primary ITP patients.

关 键 词：原发性免疫性血小板减少症 抗磷脂抗体 血栓形成 队列研究 META分析 

分 类 号：R558.2[医药卫生—血液循环系统疾病]