中国医学科学院学报

高级检索
中国医学科学院学报

中国医学科学院学报 ›› 2013, Vol. 35 ›› Issue (6): 667-671.doi: 10.3881/j.issn.1000-503X.2013.06.015

• 论著 • 上一篇    下一篇

阿加曲班在肾脏替代治疗中应用的Meta分析

曹芳芳,张海涛,冯雪,焦若男   

  1. 中国医学科学院 北京协和医学院 国家心血管病中心阜外心血管病医院心血管疾病国家重点实验室,北京 100037
  • 收稿日期:2013-03-19 出版日期:2013-12-31 发布日期:2013-12-31
  • 作者简介:张海涛 电话:010-88398466,电子邮件:fangfang8451@yeah.net

Meta-analysis of the Role of Argatroban in Renal Replacement Therapy

CAO Fang-fang, ZHANG Hai-tao, FENG Xue, JIAO Ruo-nan   

  1. State Key Laboratory of Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, CAMS and PUMC, Beijing 100037, China
  • Received:2013-03-19 Online:2013-12-31 Published:2013-12-31
  • Contact: ZHANG Hai-tao Tel:010-88398466,E-mail:fangfang8451@yeah.net

摘要: 目的 评价直接凝血酶抑制剂阿加曲班在肾脏替代治疗中应用的作用效果。方法 以“阿加曲班”、“透析”、“肾功能”、“肾功能衰竭”、“肾脏替代治疗”为关键词,在Cochrane图书馆、PubMed、EMBASE、Highwire、MEDLINE、CBM、CNKI、CSJD等中外生物医学数据库检索关于阿加曲班在肾脏替代治疗中应用的随机对照试验。采用Cochrane系统评价方法评价所纳入研究的文献质量,并提取有效数据后用RevMan 5.0软件进行Meta分析。结果 在死亡率[RR=0.97,95%CI(0.48~1.97),P=0.93]和出血发生率[RR=0.71,95%CI(0.37~1.34),P=0.29]方面,阿加曲班治疗组与对照组间差异均无统计学意义在肝素诱导的血小板减少患者的肾脏替代治疗中,阿加曲班可明显降低血栓形成的发生率[RR=0.40,95%CI(0.21~0.75),P=0.004]阿加曲班治疗组的管路凝血发生率明显低于对照组[RR=0.06,95%CI(0.01~0.23),P<0.0001]。结论 在肾脏替代治疗中应用阿加曲班可明显减低血栓及管路凝血发生,不增加死亡率与出血风险。

关键词: 阿加曲班, 肾脏替代治疗, Meta分析

Abstract: Objective To assess the role of direct thrombin inhibitor argatroban in the renal replacement therapy. Methods Electronic databases including Cochrane library, PubMed, EMBASE, Highwire, MEDLINE, CBM, CNKI, and CSJD were searched using keywords including “Argatroban”, “hemodialysis”, “renal function”, “renal failure”, and “renal replacement therapy”. A meta-analysis of all randomized controlled trials(RCTs)comparing argatroban with controls in renal replacement therapy was performed. Both the study selection and the meta-analysis were conducted according to the Cochrane Handbook for systematic reviews. Data were extracted from these trials and analyzed by RevMan 5. 0 software. Results Compared with the control group, argatroban in renal replacement therapy showed no significant difference in mortality(RR=0. 97, 95%CI:0. 48-1. 97, P=0. 93)and bleeding rate(RR=0. 71, 95%CI:0. 37-1. 34, P=0. 29). Argatroban significantly decreased the incidence of new thrombosis in renal replacement therapy for patients with heparin-induced Thrombocytopenia(RR=0. 40, 95%CI:0. 21-0. 75, P=0. 004). Also, argatroban significantly decreased the clotting events in extracorporeal circuit during the renal replacement therapy(RR=0. 06, 95%CI:0. 01-0. 23, P<0. 0001). Conclusion Argatroban applied in renal replacement therapy can decrease the incidences of new thrombosis and clotting events in extracorporeal circuit and meanwhile will not increase the mortality and bleeding.

Key words: argatroban, renal replacement therapy, meta-analysis

中图分类号: