CAJ | 학술논문

目的：与华法林及阿司匹林比较，M eta分析阿哌沙班治疗非瓣膜性房颤的有效性和安全性。方法通过检索M ed-line、Cochrane数据库、中国知网（CNKI）及万方数据库，收集2001年1月至2012年12月有关阿哌沙班与华法林及阿司匹林比较的随机对照临床试验。按纳入标准及排除标准选择文献和提取资料，采用RevMan5．1软件对患者全因病死率、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M eta分析。结果共纳入3项研究，包括24022例患者。M eta分析显示，与华法林及阿司匹林比较，阿哌沙班明显降低房颤患者全因病死率[RR＝0．88（95％ CI：0．80～0．99），P＜0．01]、脑卒中发生率[RR＝0．58（95％ CI：0．34～0．98），P＝0．04]及颅内出血发生率[RR＝0．46（95％ CI：0．34～0．61），P＜0．01]；两组周围动脉栓塞率[RR＝0．50（95％ CI：0．06～4．41），P＝0．53]及全因出血率[RR＝0．78（95％ CI：0．49～1．23），P＝0．29]无明显差异。结论阿哌沙班可有效降低房颤患者脑卒中、全因病死及颅内出血的风险，疗效优于传统药物华法林及阿司匹林。
목적：여화법림급아사필림비교，M eta분석아고사반치료비판막성방전적유효성화안전성。방법통과검색M ed-line、Cochrane수거고、중국지망（CNKI）급만방수거고，수집2001년1월지2012년12월유관아고사반여화법림급아사필림비교적수궤대조림상시험。안납입표준급배제표준선택문헌화제취자료，채용RevMan5．1연건대환자전인병사솔、뇌졸중급주위동맥전새발생솔、전인출혈급로내출혈솔진행M eta분석。결과공납입3항연구，포괄24022례환자。M eta분석현시，여화법림급아사필림비교，아고사반명현강저방전환자전인병사솔[RR＝0．88（95％ CI：0．80～0．99），P＜0．01]、뇌졸중발생솔[RR＝0．58（95％ CI：0．34～0．98），P＝0．04]급로내출혈발생솔[RR＝0．46（95％ CI：0．34～0．61），P＜0．01]；량조주위동맥전새솔[RR＝0．50（95％ CI：0．06～4．41），P＝0．53]급전인출혈솔[RR＝0．78（95％ CI：0．49～1．23），P＝0．29]무명현차이。결론아고사반가유효강저방전환자뇌졸중、전인병사급로내출혈적풍험，료효우우전통약물화법림급아사필림。
Objective To analysis of the efficacy and safety of Apixaban versus warfarin and aspirin in patients with atrial fibril-lation .Methods The Medline ,Cochrane database ,CNKI database and Chinese WanFang were searched to collect data from ran-domized controlled trials about Apixaban compared with Warfarin or aspirin in patients with atrial fibrillation from January 1st , 2001 to December 1st ,2012 .Meta-analysis of data including death from any cause ,stroke ,periphery embolism ,major bleeding and intracranial bleeding were carried out by using the RevMan5 .1 package .Results A total of 24 022 patients with atrial fibrillation were collected from 3 studies .Compared with Warfarin and aspirin ,the lower rates of death from any cause [RR=0 .88(95% CI:0 .80-0 .99) ,P<0 .01] ,stroke [RR= 0 .58(95% CI:0 .34-0 .98) ,P= 0 .04] and intracranial bleeding [RR= 0 .46(95% CI:0 .34-0 .61) ,P< 0 .01] were observed in patients with atrial fibrillation by using Apixaban ;there were no differences between Apixaban group and the Warfarin and aspirin group about periphery embolism [RR=0 .50(95% CI:0 .06 -4 .41) ,P=0 .53] and major bleeding [RR=0 .78(95% CI:0 .49 -1 .23) ,P= 0 .29] .Conclusion The effects of the Oral Anticoagulants (Apixaban) which had the lower risk of death ,stroke and intracranial bleeding were beter than the traditional drug warfarin and aspirin .