CAJ | 학술논문

目的：评价达比加群酯对非瓣膜性房颤患者抗凝治疗的效果及安全性。方法检索有关达比加群酯对非瓣膜性房颤患者抗凝治疗的随机对照试验及多中心对照研究等文献，并进行质量评估，采用RevMan 5|．2对符合条件的研究进行Meta分析，评价达比加群酯对非瓣膜性房颤患者的抗凝效果及安全性。结果符合纳入标准的文献共7篇（中文1篇，英文6篇），总样本量为33502例。 Meta分析显示，与华法林比较，达比加群酯明显降低房颤患者脑卒中发生率（OR＝0．82，95％CI 0．73～0．93， P ＝0．001）、全因出血率（OR＝0．86，95％CI 0．79～0．95， P ＝0．003）及颅内出血发生率（OR＝0．42，95％CI 0．29～0．62， P ＝0．001）；而动脉栓塞率（OR＝0．75，95％CI 0．45～1．25， P ＝0．28）及全因死亡率（OR＝0．91，95％CI 0．82～1．00， P ＝0．06）无明显差异。结论达比加群酯可有效降低房颤患者脑卒中、全因出血及颅内出血的风险，疗效优于传统药物华法林且安全性高。
목적：평개체비가군지대비판막성방전환자항응치료적효과급안전성。방법검색유관체비가군지대비판막성방전환자항응치료적수궤대조시험급다중심대조연구등문헌，병진행질량평고，채용RevMan 5|．2대부합조건적연구진행Meta분석，평개체비가군지대비판막성방전환자적항응효과급안전성。결과부합납입표준적문헌공7편（중문1편，영문6편），총양본량위33502례。 Meta분석현시，여화법림비교，체비가군지명현강저방전환자뇌졸중발생솔（OR＝0．82，95％CI 0．73～0．93， P ＝0．001）、전인출혈솔（OR＝0．86，95％CI 0．79～0．95， P ＝0．003）급로내출혈발생솔（OR＝0．42，95％CI 0．29～0．62， P ＝0．001）；이동맥전새솔（OR＝0．75，95％CI 0．45～1．25， P ＝0．28）급전인사망솔（OR＝0．91，95％CI 0．82～1．00， P ＝0．06）무명현차이。결론체비가군지가유효강저방전환자뇌졸중、전인출혈급로내출혈적풍험，료효우우전통약물화법림차안전성고。
Objective To evaluate effect and safety of dabigatran etexilate for the treatment of non valvular atrial fi -brillation anticoagulation .Methods Retrieval review literature of randomized controlled trial and multi-center study of dabiga-tran etexilate for the anticoagulation treatment in patients with non valvular atrial fibrillation , and performed the quality assess-ment, the RevMan 5.2 were used to performed the Meta-analysis for these studies, to evaluate dabigatran etexilate anticoagu-lant effect and safety for patients with non valvular atrial fibrillation .Results 7 papers met the inclusion criteria were enrolled (1 English, 6 Chinese papers), included 33 502 patients.Meta-analysis showed that, compared with warfarin, dabigatran significantly reduce the incidence of cerebral apoplexy in AF patients (OR=0.82, 95%CI, 0.73-0.93, P =0.001), all-cause hemorrhage rate (OR=0.86, 95%CI 0.79-0.95, P =0.003) and intracranial hemorrhage (OR=0.42, 95%CI, 0.29-0.62, P =0.001) ;and arterial embolism rate (OR=0.75, 95%CI 0.45-1.25, P =0.28) and all-cause mortality (OR=0.91, 95%CI, 0.82-1.00, P =0.06) had no significant difference .Conclusion Dabigatran can effectively reduce the cerebral apoplexy , all-cause bleeding and the risk of intracranial hemorrhage in AF patients , the curative effect is better than traditional warfarin .