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1、新型抗凝药治疗非瓣膜性房颤的有效性和安全性荟萃分析李庆勇1牛锁成1(通讯作者)牛好敏1管文娟1龙爱芳1杨颖1杨跃进2(1濮阳市人民医院心内二科安徽濮阳457000)(2中国医学科学院阜外心血管病医院北京100037)【摘要】目的：荟萃分析新型抗凝药(阿哌沙班、利伐沙班、达比加群)同华法林比较治疗房颤的有效性和安全性。方法：通过检索Medline、Cochrane数据库、中国知网(CNKI)及万方数据库，收集2001年1月至2014年12月期间有关阿哌沙班、利伐沙班、达比加群与华法林比较的随机对照临床试验。按纳入标准及
2、排除标准选择文献，提取资料，采用RevMan5.1软件对患者全因死亡率、脑卒中及周围动脉栓塞发生率、全因出血及颅内出血率进行荟萃分析。结果：共纳入4项研究，乜括64805例患者。荟萃分析显示：同华法林比较，新型抗凝药物(阿哌沙班、利伐沙班、达比加群)组明显降低房颤患者全因死亡率［RR=0.91(95%CI:0.86-0.97),P=0.002］、脑卒中发生率［RR=0.81(95%CI:0.73-0.89),P<0.001］、周围动脉栓塞率［RR=0.70(95%CI:0.50-0.97),P=0.03］及颅内出血发
3、牛.率［RR=0.50(95%CI:0.37-0.69),P<0.001］；两组全因出血率［RR=0.90(95%CI:0.73-1.10),P=0.29］无明显差异。结论：新型口服抗凝药物(阿哌沙班、利伐沙班、达比加群)可有效降低房颤患者脑卒中及死亡的风险，同时避免了颅内出血风险的增加，疗效优于传统药物华法林。【关键词】心房颤动；阿哌沙班；利伐沙班；达比加群；华法林【中图分类号】R453【文献标识码】A【文章编号】2095-1752(2015)10-0030-03Meta-Analysisofefficacyand
4、safetyofNewOralAnticoagulants(Apixaban&Rivaroxaban&Dabigatran)VersusWarfarininPatientswithatrialfibrillationLiQingyongl,NiuSuochengl,NiuHaominl,GuanWenjuanl,LongAifangl,YangYingl1People’sHospitalofPuyang,He’nanProvince,Puyang457000,China;Yan
5、gYuejin22FuwaiCardiologyHospitalofChineseAcademyofMedicalSciences,Beijing100037,China【Abstract】ObjectiveToanalysisoftheefficacyandsafetyofNewOralAnticoagulants(Apixaban&Rivaroxaban&Dabigatran)VersusWarfarininPatientswithatrialfibrillation.MethodsTheMedl
6、ine,Cochranedatabase,CNKIdatabaseandChineseWanFangweresearchedtocollectdatafromrandomizedcontrolledtrialsabouttheNewOralAnticoagulants(Apixaban&Rivaroxaban&Dabigatran)comparedwithWarfarininPatientswithatrialfibrillationfromJanuary,2001toDecember,2014.Me
7、ta-analysisofdateincludingdeathfromanycause,stroke,peripheryembolism,majorbleedingandintracranialbleedingwerecarriedoutbyusingtheRevMan5.1package.ResultsAtotalof64,805patientswithatrialfibrillationwerecollectedfrom4studies.ComparedwithWarfarin,thelowerratesofde
8、athfromanycause[RR=0.91(95%CI:0.86-0.97)/P=0.002]/stroke[RR=0.81(95%CI:0.73-0.89)/P<0.001],peripheryembolism[RR=0.70(95%CI:0.50-0.97),P=0.03]andintracranialbleeding[RR=0.
