汪浩,孟凡华,马翔,马依彤

• 1:新疆医科大学第一附属医院冠心病二科

摘要(Abstract)：

目的系统评价经导管主动脉瓣置入术(transcatheter aortic valve implantation,TAVI)后抗血小板治疗的有效性和安全性。方法计算机检索Pub Med、EMbase、The Cochrane Library(2016年1期)、CBM、CNKI、万方数据库,收集TAVI术后单联抗血小板与双联抗血小板治疗的相关随机对照研究和队列研究。由2位研究者按照纳入与排除标准筛选文献,提取资料和评价质量后,采用Cochrane协作网提供的Rev Man 5.3统计软件进行Meta分析。结果共纳入4项研究,其中2项随机对照研究,2项队列研究。有效性结果分析显示:TAVI术后行单联抗血小板与双联抗血小板治疗随访1个月的脑卒中(OR 0.55,95%CI 0.22~1.35,P=0.19)、心肌梗死(OR 1.70,95%CI 0.25~11.65,P=0.59)以及全因死亡率(OR 0.77,95%CI 0.40~1.49,P=0.44)比较,差异均无统计学意义。安全性结果分析显示:TAVI术后行单联抗血小板较双联抗血小板治疗随访1个月出血事件发生率降低,差异有统计学意义(OR 0.37,95%CI 0.23~0.59,P<0.0001)。结论单联抗血小板与双联抗血小板治疗在预防TAVI术后患者脑卒中、心肌梗死、全因死亡方面的疗效相当。单联抗血小板较双联抗血小板治疗的出血事件发生率降低。受纳入研究数量和质量的限制,上述结论尚需开展更多高质量随机对照试验予以验证。

关键词(KeyWords)： 经导管主动脉瓣置入术;抗血小板治疗;Meta分析

Abstract:

Keywords:

基金项目(Foundation): 新疆杰出青年自然科学基金项目(2014711003)

作者(Author): 汪浩,孟凡华,马翔,马依彤

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