替格瑞洛对比普拉格雷对血小板反应性影响的Meta分析 点击下载
论文标题: 替格瑞洛对比普拉格雷对血小板反应性影响的Meta分析
英文标题:
中文摘要: 目的:系统评价替格瑞洛对比普拉格雷对血小板反应性的影响,以为临床治疗提供循证参考。方法:计算机检索PubMed、中国期刊全文数据库和万方数据库,收集替格瑞洛对比普拉格雷对血小板反应性影响的随机对照试验(RCT)和对照试验,对符合纳入标准的临床研究进行资料提取,并采用Cochrane系统评价员手册5.1.0进行质量评价,再采用Rev man 5.1统计软件进行Meta分析。结果:共纳入17项RCT,合计2 757例患者。Meta分析结果显示,负荷剂量下,无论采用Verify Now P2Y12(VN)检测法[MD=15.43,95%CI(-0.39,31.25),P=0.06]或血管扩张刺激磷酸蛋白(VASP)检测法[MD=-3.04,95%CI(-8.98,2.90),P=0.32],替格瑞洛与普拉格雷对血小板反应性的效果相当,两组比较差异均无统计学意义;维持剂量下,无论采用VN检测法[MD=-48.94,95%CI(-58.04,-39.84),P<0.001]或VASP检测法[MD=-14.32,95%CI(-20.45,-8.20),P<0.001],替格瑞洛对血小板反应性的效果均优于普拉格雷,两组比较差异均有统计学意义。结论:在初期负荷剂量使用抗血小板药物时,选用替格瑞洛或普拉格雷对血小板反应性的影响没有显著差异,而后期维持剂量使用抗血小板药物时,替格瑞洛对血小板反应性的效果优于普拉格雷。
英文摘要: OBJECTIVE:To systematically review the effect of ticagrelor versus prasugrel on platelet reactivity, and provide evidence-based reference for clinical treatment. METHODS: Retrieved from PubMed, CJFD and Wanfang Database, randomized controlled trials (RCT) about the effect of ticagrelor versus prasugrel on platelet reactivity were collected. Meta-analysis was performed by using Rev Man software after data extract and quality evaluation by Cochrane 5.1.0. RESULTS: Totally 17 RCTs were enrolled, involving 2 757 patients. Results of Meta-analysis showed, regardless of Verity Now (VN) detection method [MD=15.43, 95%CI(-0.39,31.25),P=0.06] or vasodilator stimulus phosphoprotein (VASP) detection method [MD=-3.04, 95%CI(-8.98,2.90), P=0.32], ticagrelor and prasugrel had the same effects on platelet reactivity under loading dose, the differences were not statistically significant; regardless of VN detection method [MD=-48.94, 95%CI(-58.04,-39.84),P<0.001] or VASP detection method [MD=-14.32, 95%CI(-20.45,-8.20), P<0.001], the effects of ticagrelor were better than prasugrel on platelet reactivity under maintenance dose, the differences were statistically significant. CONCLUSIONS: At the loading dose, there was no difference between ticagrelor and prasugrel, but ticagrelor has more benefits than prasugrel under maintenance dose.
期刊: 2016年第27卷第15期
作者: 吴禹蒙,程荔春,梁晶,刘利龙,孙向菊,宋佳,吴玉波
英文作者: WU Yumeng,CHENG Lichun,LIANG Jing,LIU Lilong,SUN Xiangju,SONG Jia,WU Yubo
关键字: 替格瑞洛;普拉格雷;血小板反应性;Meta分析
KEYWORDS: Ticagrelor; Prasugrel; Platelet reactivity; Meta-analysis
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