替格瑞洛治疗亚洲人急性冠状动脉综合征的Meta分析  

Ticagrelor in Asian patients with acute coronary syndromes:a Meta-analysis

作　　者：贾冬霞[1] 彭君臣[1] 刘思泰[1] JIA Dongxia;PENG Junchen;LIU Sitai(Department of General Medicine,MianYang 404 hospital,Mianyang 621000,China)

机构地区：[1]四川绵阳四0四医院全科医学科,621000

出　　处：《心肺血管病杂志》2022年第5期549-556,共8页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:系统评价替格瑞洛治疗亚洲人群急性冠状动脉综合征(ACS)的有效性与安全性。方法:检索PubMed、EMBase、Cochrane Library、中国学术期刊数据库(CNKI)、中国生物医学文献数据库(CBM),检索时间限为建库至2021年7月。纳入关于替格瑞洛治疗亚洲人群ACS的随机对照试验,由两名评价者独立评价研究质量,提取资料,交叉核对后,采用RevMan5.3进行Meta分析。结果:纳入17项研究共11161例。Meta分析结果显示:替格瑞洛组与氯吡格雷组相比脑卒中发生率(OR=0.84,95%CI:0.57~1.26,P=0.41)、支架内血栓行成率(OR=0.71,95%CI:0.46~1.09,P=0.12)、心肌梗死发生率(OR=0.94,95%CI:0.72~1.23,P=0.65)、心动过缓发生率(OR=1.23,95%CI:0.76~1.99,P=0.41)、靶血管再通发生率(OR=0.54,95%CI:0.27~1.11,P=0.10),差异均无统计学意义,但出血发生率(OR=1.36,95%CI:1.15,1.61,P=0.0003)、呼吸困难发生率(OR=1.92,95%CI:1.38~2.66,P<0.0001)替格瑞洛组高于氯吡格雷组,且有统计学差异,死亡发生率(OR=0.53,95%CI:0.39~0.72,P<0.0001)、心绞痛发生率(OR=0.42,95%CI:0.26~0.68,P=0.0004)替格瑞洛组低于氯吡格雷组,且差异有统计学意义。结论:替格瑞洛治疗亚洲人群ACS虽然出血、呼吸困难发生率高于氯吡格雷组,但心绞痛、死亡发生率较氯吡格雷低,具有较好疗效和安全性。Objective:To systematically evaluate the efficacy and safety of Ticagrelor in Asian Patients with acute coronary syndromes(ACS).Methods:The randomized trials on Ticagrelor versus clopidogrel in Asian ACS patients in the PubMed,EMBase,Cochrane Library,CNKI,CBM date from the day of their establishment to July 2021 were collected.Assessement and data extraction were conducted by two reviewers independently,Meta-ananlysis was performed by RevMan5.3.Results:17 studies involving 11161 patients were included.And the Meta-analysis showed that there was no statistical difference between Ticagrelor and Clopidogrel in the incidence of stroke(OR=0.84,95%CI:0.57-1.26,P=0.41),stent thrombosis(OR=0.71,95%CI:0.46-1.09,P=0.12)、MI(OR=0.94,95%CI:0.72-1.23,P=0.65),bradycardia(OR=1.23,95%CI:0.76-1.99,P=0.41)、revascularization(OR=0.54,95%CI:0.27-1.11,P=0.10),but there was statistical difference of the incidence of bleeding(OR=1.36,95%CI:1.15-1.61,P=0.0003],dyspnea(OR=1.92,95%CI:1.38-2.66,P<0.0001),death(OR=0.53,95%CI:0.39-0.72,P<0.0001)、angina(OR=0.42,95%CI:0.26-0.68,P=0.0004).Conclusions:Compared with clopidogrel the incidence of bleeding and dyspnea of Ticagrelor was more higher but the incidence of death and angina was lower.Ticagrelor has relatively good efficacy and safety in Asian Patients with Acute Coronary Syndromes.

关 键 词：替格瑞洛 亚洲人群 氯吡格雷 急性冠状动脉综合征 META分析 

分 类 号：R54[医药卫生—心血管疾病]