两种抗血小板药物治疗心肌梗死疗效及安全性对比的荟萃分析  

A Meta-Analysis Comparing The Efficacy And Safety of Two Antiplatelet Agents in The Treatment of Myocardial Infarction

作　　者：董文静 黄川生[1,2] 王新春 DONG Wen-jing;HUANG Chuan-sheng;WANG Xin-chun(Pharmacy School of Shihezi University,Xinjiang Shihezi,832002;The First Affiliated Hospital of Shihezi University,Xinjiang Shihezi,832008)

机构地区：[1]石河子大学药学院,新疆石河子832002 [2]石河子大学第一附属医院药学部,新疆石河子832008

出　　处：《农垦医学》2023年第6期494-501,共8页Journal of Nongken Medicine

摘　　要：目的:系统评价氯吡格雷或替格瑞洛治疗心肌梗死的疗效及安全性。方法:计算机检索PubMed、Cochrane Library、CNKI等数据库,收集氯吡格雷和替格瑞洛的RCT、队列研究文献。采用Downs and Black工具质量评价对纳入的文献进行质量评价后提取数据进行Meta统计分析。结果:Meta分析结果显示,氯吡格雷术后血流通量TIMIⅢ级显著低于替格瑞洛组[OR=0.31,95%CI(0.23~0.42),P<0.00001];氯吡格雷术后出血事件显著低于替格瑞洛组[OR=0.67,95%CI (0.59~0.76),P<0.00001];替格瑞洛组主要心血管不良事件的发生率低[RR=1.22,95%CI(1.10~1.35),P=0.0001];不良反应事件氯吡格雷组发生率低[OR=1.15,95%CI(1.03~1.30),P=0.01];死亡事件二者无显著性差异[RR=0.93,95%CI(0.80~1.08),P=0.35]。结论:氯吡格雷较替格瑞洛在心肌梗死患者治疗中的有效性相对较差,但安全性方面相对较优。Objective:Evaluating the efficacy and safety of clopidogrel or ticagrelor in the treatment of myocardial infarction systematically.Methods:Computer searches of PubMed,Cochrane Library,CNKI and other databases were conducted to collect the literature of RCTs and cohort studies of clopidogrel and ticagrelor.Data were extracted for Meta-statistical analysis after quality evaluation of the included literature using Downs and Black tool quality evaluation.Results:Meta-analysis showed that postoperative blood flow TIMI grade III was significantly lower in the clopidogrel than in the ticagrelor group[OR=0.31,95%CI(0.23-0.42),P<0.00001];postoperative bleeding events were significantly lower in the clopidogrel than in the ticagrelor group[OR=0.67,95%CI(0.59-0.76),P<0.00001];The incidence of major cardiovascular adverse events was lower in the ticagrelor group[RR=1.22,95%CI(1.10~1.35),P=0.0001];the incidence of adverse events was lower in the clopidogrel group[OR=1.15,95%CI(1.03~1.30),P=0.01];there was no significant difference between the two for fatal events[RR=0.93,95%CI(0.80 to 1.08),P=0.35].Conclusion:Clopidogrel is relatively less effective than ticagrelor in the treatment of patients with myocardial infarction,but is relatively superior in terms of safety.

关 键 词：氯吡格雷 替格瑞洛 心肌梗死 疗效 安全性 经皮冠状动脉介入术 

分 类 号：R542.22[医药卫生—心血管疾病]