预防性抗凝治疗对预防肝硬化门静脉血栓形成的疗效及安全性meta分析  

Efficacy and safety of prophylactic anticoagulant therapy in prevention of portal vein thrombosis in liver cirrhosis:a meta analysis

作　　者：江婷婷 胡榆雪 高建[1] JIANG Tingting;HU Yuxue;GAO Jian(Department of Gastroenterology,Second Affiliated Hospital of Chongqing Medical University,Chongqing400010,China)

机构地区：[1]重庆医科大学附属第二医院消化内科,重庆400010

出　　处：《现代医药卫生》2018年第6期813-816,共4页Journal of Modern Medicine & Health

基　　金：国家自然科学基金资助项目(81572888)

摘　　要：目的评价预防性抗凝治疗对预防肝硬化门静脉血栓形成的疗效及安全性。方法通过计算机检索Pub Med、Cochrane图书馆、Embase、谷歌学术等英文数据库建库至2017年6月25日有关预防性抗凝治疗对肝硬化门静脉血栓形成疗效的随机对照试验的文献,使用Jadad量表对纳入文献的方法学质量进行评价,采用Statal2.0统计软件进行meta分析。结果共纳入5篇文献,且均为随机对照研究,共331例肝硬化门静脉血栓患者,其中依诺肝素抗凝治疗162例(抗凝组),安慰剂治疗169例(安慰剂组)。meta分析结果显示,与安慰剂组比较,抗凝组降低了第1、2年门静脉血栓发生率及肝功能失代偿发生率,差异均有统计学意义(RR=0.08、0.19、0.21,95%CI 0.02~0.29、0.09~0.38、0.13~0.34,P=0.000、0.000、0.000);而抗凝组出血率及死亡率与抗凝组比较,差异均无统计学意义(RR=1.32、0.63,95%CI 0.52~3.35、0.38~1.06,P=0.560、0.085)。结论预防性抗凝治疗可有效、安全地预防肝硬化门静脉血栓形成,值得临床推广应用。Objective To evaluate the efficacy and safety of prophylactic anticoagulant therapy in the prevention of portal vein thrombosis in liver cirrhosis.Methods The literatures of randomized controlled trials(RCT)on prophylactic anticoagulant therapy for preventing portal vein thrombosis in liver cirrhosis were retrieved from PubMed,Embase,Cochrane Library databases and Google Scholar by computer from their establishment to June25,2017.The Jadad scale was used for conducting the methodological quality assessment on the included literatures.The Stata12.0statistical software was used for conducting meta analysis.Results Five articles of RCT were included,involving331cases of cirrhosis portal vein thrombosis,including162cases of enoxaparin anticoagulation treatment(anticoagulation group)and169cases of placebo treatment(placebo group).The meta analysis results showed that compared with the placebo group,the anticoagulation group reduced the incidence rates of portal vein thrombosis and liver function decompensation in the first year and second year,the differences were statistically significant(RR=0.08,0.19,0.21,95%CI0.02~0.29,0.09~0.38,0.13~0.34,P=0.000,0.000,0.000).However the hemorrhage rate and mortality rate had no statistical differences between the anticoagulation group and placebo group(RR=1.32,0.63,95%CI0.52?3.35,0.38?1.06,P=0.560,0.085).Conclusion Prophylactic anticoagulant therapy can effectively and safely prevent cirrhosis portal vein thrombosis and is worth promotion and application in clinic.

关 键 词：肝硬化 门静脉 血栓形成 抗凝治疗 依诺肝素 META分析 

分 类 号：R575.2[医药卫生—消化系统]