J Stroke Cerebrovasc Dis:抗血小板药物增加脑微出血?亚洲与欧洲截然相反

2015-09-10 phylis 译 MedSci原创

背景:抗血小板治疗是脑内出血的潜在危险因素,并且脑微出血反应的是小外周血管出血,并无临床症状。问题是,抗血小板治疗是否增加脑微出血的危险尚无定论。方法:研究人员在英文数据库中进行搜索,选出评估抗血小板治疗和脑微出血的关系的研究。然后,研究人员应用Review Manager 5.2用逆方差法计算总OR值。结果:研究人员选取11个研究,共10429名受试者。结果显示抗血小板治疗与脑出血卒中患者 (O

背景:抗血小板治疗是脑内出血的潜在危险因素,但是脑微出血是小外周血管出血,并无临床症状。因此,抗血小板治疗是否增加脑微出血的危险尚无定论。

方法:研究人员在英文数据库中进行搜索,选出评估抗血小板治疗和脑微出血的关系的研究。然后,研究人员应用Review Manager 5.2用逆方差法计算总OR值。

结果:研究人员选取11个研究,共10429名受试者。结果显示抗血小板治疗与脑出血卒中患者 (OR, 1.96; 95% CI, 1.22-3.16)、缺血性卒中患者(OR, 1.65; 95% CI, 1.06-2.59)中脑微出血有明显相关,但二者在非卒中人群(OR, 1.30; 95% CI, .96-1.74)无相关性。


对人群种族进行分层分析,在亚洲国家,患者进行抗血小板治疗与脑出血卒中患者(OR, 2.26; 95% CI, 1.25-4.08),缺血性卒中患者(OR, 2.18; 95% CI, 1.02-4.67)中脑微出血存在明显相关。而在欧洲国家患者中,抗血小板治疗与脑出血卒中患者(OR, 1.95; 95% CI, .33-11.37)、缺血性卒中患者(OR, 1.16; 95% CI, .87-1.54)的微出血中无明显相关。

结论:抗血小板治疗可能增加卒中患者脑微出血的可能性。另外,抗血小板治疗与脑微出血之间的关系可能受到种族的影响。目前为止,相关的大多研究为回顾性研究,并且可用数据有限,需仍要更大的前瞻性研究证实这个结果。

原文出处:

Liu S, Li C. Antiplatelet Drug Use and Cerebral Microbleeds: A Meta-analysis of Published Studies. J Stroke Cerebrovasc Dis. 2015 Aug 10. pii: S1052-3057(15)00291-8. doi: 10.1016/j.jstrokecerebrovasdis.2015.05.022. [Epub ahead of print]

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    2016-01-19 quxin068
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