新型P2Y12受体拮抗剂与氯吡格雷治疗PCI患者的Meta分析

方冬; 万静; 方奇; 李凯勇; 丁氏兰瑛; 彭松

doi:10.13201/j.issn.1001-1439.2015.05.007

新型P2Y12受体拮抗剂与氯吡格雷治疗PCI患者的Meta分析

- 武汉大学中南医院心内科(武汉, 430071)

详细信息

作者简介:
万静,E-mail:wanjing320@aliyun.com

中图分类号: R541.4

收稿日期: 2014-10-13

New P2Y12 inhibitors and clopidogrel for percutaneous coronary intervention:A Meta-analysis

- Department of Cardiology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China

Received Date: 13 October 2014

摘要

摘要: 目的:系统评价新型P2Y12受体拮抗剂与氯吡格雷在PCI患者中的疗效和安全性。方法:检索Pubmed、MEDLINE、EMbase、The Cochrane Library(2014年7期)、CNKI、万方数据库,从中找到有关新型P2Y12受体拮抗剂与氯吡格雷在PCI患者中比较治疗的随机对照试验(RCT),检索时限截止至2014年7月31日。由2位评价者按照纳入与排除标准独立筛选文献,提取资料并严格评价纳入研究的方法学质量,采用RevMan5.2软件进行Meta分析。结果:共纳入12个RCT,共收集71 097例患者的资料。Meta分析显示:新型P2Y12受体拮抗剂可有效降低PCI患者的全因死亡(OR:0.81;95%CI:0.73~0.90;P<0.0001)、主要不良心血管事件(OR:0.81;95%CI:0.73~0.90;P<0.0001)及支架内血栓形成(OR:0.58;95%CI:0.49~0.69;P<0.00001)的发生率;而在心肌梗死溶栓后大出血事件(OR:1.24;95%CI:1.00~1.53;P=0.05)方面,新型P2Y12受体拮抗剂与氯吡格雷均无统计学差别。结论:相较于氯吡格雷,新型P2Y12受体拮抗剂可以有效改善PCI患者远期治疗结局,但仍须谨慎出血性事件的发生。
- 新型P2Y12受体拮抗剂 /
- 氯吡格雷 /
- 经皮冠状动脉支架植入术 /
- 随机双盲对照试验
Abstract: Objective:To systematically evaluate the efficacy and safety of new P2Y12 inhibitors and clopidogrel in percutaneous coronary intervention.Method:We searched the data bases including Pubmed,MEDLINE,EMbase,The Cochrane Library(issue7,2014),CNKI,WangFang Data about the randomized controlled trials(RCTs) about the efficacy and safety of new P2Y12 inhibitors and clopidogrel till July 31 st,2014.According to the inclusion and exclusion criteria,two evaluaters screened the literature,extracted the data,and evaluated the methodological quality of the included studies.Meta-analysis was performed by using the RevMan 5.1software.Result:Twelve studies were included which all came from overseas.The Meta-analysis showed that compared with clopidogrel,new P2Y12 inhibitors reduced all-cause death(OR:0.81;95%CI:0.73-0.90;P<0.0001),MACE(OR:0.81;95%CI:0.73-0.90,P<0.0001) and stent thrombosis(OR:0.58;95%CI:0.49-0.69,P<0.00001),However,there was no significant difference between new inhibitors and clopidogrel on the hemorrhagic events(OR:1.24;95%CI:1.00-1.53,P=0.05).Conclusion:New P2Y12 inhibitors can improve long-term outcomes after PCI compared with clopidogrel.However,the risk of hemorrhagic events should still be treated with caution.
- new P2Y12Inhibitors /
- clopidogrel /
- percutaneous coronary intervention /
- randomized controlled trials

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