国际肿瘤学杂志
國際腫瘤學雜誌
국제종류학잡지
JOURNAL OF INTERNATIONAL ONCOLOGY
2011年
12期
943-947
,共5页
张元莉%关泉林%王千千%史树勋
張元莉%關泉林%王韆韆%史樹勛
장원리%관천림%왕천천%사수훈
阿司匹林%化学预防%结直肠肿瘤%Meta分析
阿司匹林%化學預防%結直腸腫瘤%Meta分析
아사필림%화학예방%결직장종류%Meta분석
Aspirin%Chemprevention%Colorectal neoplasms%Meta-analysis
目的 对已发表的文献进行Meta分析,评价服用阿司匹林对结直肠腺瘤的化学预防.方法 采用Cochrane系统评价方法,检索PubMed、EMBase、Cochrane Library、中国期刊全文数据库(CNKI)、中国生物医学文献数据库(CBM)、中文科技期刊全文数据库(CSJD)等,并辅以手工检索和其他检索.结果 共6个随机对照试验2 858例患者纳入研究,其中4个随机对照研究来自欧美国家,2个来自中国.Meta分析结果显示阿司匹林可以预防结直肠腺瘤的复发(P=0.003,RR =0.66,95％CI:0.50～0.86),对预防结直肠癌的发生无统计学意义(P--0.29,RR =0.65,95％ CI:0.30～1.44).亚组分析显示,服用高剂量(≥300 mg/d)、低剂量(＜300 mg/d)阿司匹林均可影响结直肠腺瘤的发生(P=0.10,RR =0.85,95％ C1:0.71～1.03;P=0.02,RR =0.57,95％ CI:0.36～0.90),显示阿司匹林预防腺瘤复发有剂量依赖关系.各剂量阿司匹林组间不良反应的发生无统计学意义,但中风的发生高于安慰剂组(P=0.04).结论 长期服用阿司匹林可以降低结直肠腺瘤的复发,但对结直肠癌的发生无影响.
目的 對已髮錶的文獻進行Meta分析,評價服用阿司匹林對結直腸腺瘤的化學預防.方法 採用Cochrane繫統評價方法,檢索PubMed、EMBase、Cochrane Library、中國期刊全文數據庫(CNKI)、中國生物醫學文獻數據庫(CBM)、中文科技期刊全文數據庫(CSJD)等,併輔以手工檢索和其他檢索.結果 共6箇隨機對照試驗2 858例患者納入研究,其中4箇隨機對照研究來自歐美國傢,2箇來自中國.Meta分析結果顯示阿司匹林可以預防結直腸腺瘤的複髮(P=0.003,RR =0.66,95％CI:0.50～0.86),對預防結直腸癌的髮生無統計學意義(P--0.29,RR =0.65,95％ CI:0.30～1.44).亞組分析顯示,服用高劑量(≥300 mg/d)、低劑量(＜300 mg/d)阿司匹林均可影響結直腸腺瘤的髮生(P=0.10,RR =0.85,95％ C1:0.71～1.03;P=0.02,RR =0.57,95％ CI:0.36～0.90),顯示阿司匹林預防腺瘤複髮有劑量依賴關繫.各劑量阿司匹林組間不良反應的髮生無統計學意義,但中風的髮生高于安慰劑組(P=0.04).結論 長期服用阿司匹林可以降低結直腸腺瘤的複髮,但對結直腸癌的髮生無影響.
목적 대이발표적문헌진행Meta분석,평개복용아사필림대결직장선류적화학예방.방법 채용Cochrane계통평개방법,검색PubMed、EMBase、Cochrane Library、중국기간전문수거고(CNKI)、중국생물의학문헌수거고(CBM)、중문과기기간전문수거고(CSJD)등,병보이수공검색화기타검색.결과 공6개수궤대조시험2 858례환자납입연구,기중4개수궤대조연구래자구미국가,2개래자중국.Meta분석결과현시아사필림가이예방결직장선류적복발(P=0.003,RR =0.66,95％CI:0.50～0.86),대예방결직장암적발생무통계학의의(P--0.29,RR =0.65,95％ CI:0.30～1.44).아조분석현시,복용고제량(≥300 mg/d)、저제량(＜300 mg/d)아사필림균가영향결직장선류적발생(P=0.10,RR =0.85,95％ C1:0.71～1.03;P=0.02,RR =0.57,95％ CI:0.36～0.90),현시아사필림예방선류복발유제량의뢰관계.각제량아사필림조간불량반응적발생무통계학의의,단중풍적발생고우안위제조(P=0.04).결론 장기복용아사필림가이강저결직장선류적복발,단대결직장암적발생무영향.
Objective To assess the effect of aspirin for the chemoprevention of colorectal adenomas by meta analysis of the published literature.Methods Cochrane strategy in combination with manual search was used to identify previously published randomized controlled trials by searching PubMed,EMBase,Cochrane Library,China Journal Full-text Database(CNKI),Chinese Scientific Journal Full-text Database (CSJD) and Chinese Biomedical Literature Database (CBM).Results Six randomized controlled trials involving a total of 2 858 patients were studied.Of the six trials,two trials were performed in China,four trials were in the Europe and the United States.Some sufficient evidence were found to support that aspirin could prevent of colorectal adenomas compared with placebo group ( P =0.003,RR =0.66,95％ CI:0.50-0.86).No adaquate evidence supported the role of aspirin in the prevention of development of colorectal cancer ( P =0.29,RR =0.65,95％ CI:0.30-1.44).High-dose aspirin ( P =0.10,RR =0.85,95％ CI:0.71-1.30 ) and low-dose aspirin could prevent colorectal adenomas compared with placebo group( P =0.02,RR =0.57,95％ CI:0.36-0.90),and a dose-dependent associtation was found.The risk of stroke was higher in any dose of aspirin compared with placebo group ( P =0.04),and the risks of adverse events had no significant differences in all groups.Conclusion Aspirin might prevent the development of colorectal adenomas in individuals,but could not prevent the colorectal cancer.
