BMJ:低剂量阿司匹林作为下肢静脉性溃疡辅助治疗靠谱吗?

2017-11-24 xing.T MedSci原创

由此可见,该研究的结果并不支持使用低剂量阿司匹林作为下肢静脉溃疡的辅助治疗。

近日,顶级杂志BMJ上发表了一篇研究文章,研究人员旨在评估低剂量阿司匹林对下肢静脉溃疡患者溃疡愈合的影响。

该研究是以社区为基础的、设立了平行组的双盲随机对照试验,是在新西兰五个社区护理中心内完成的。该研究的参与者为251名下肢静脉溃疡的成年人,这些换可以安全地接受阿司匹林或安慰剂治疗:125名患者被随机分配入阿司匹林组和126名患者被随机分配入安慰剂组。这些受试者接受了150mg口服阿司匹林或安慰剂治疗长达24周,挤压治疗作为标准的背景治疗。

该研究的主要观察指标为参考溃疡(如果存在多个溃疡选取最大的溃疡)完全愈合时间。次要结局指标为受试者的治愈比例、溃疡面积的改变、健康相关生活质量的改变以及不良事件。采用意向性治疗分析。

研究人员发现阿司匹林组受试者愈合时间中位数为77天,安慰剂组为69天(风险比为0.85,95%可信区间为0.64-1.13,P=0.25)。研究终点时受试者愈合人数在阿司匹林组为88人(70%),在安慰剂组为101人(80%)(风险差异为-9.8%,95%可信区间为-20.4%至0.9%,P=0.07)。阿司匹林组溃疡面积估计变化为4.1cm2,在安慰剂组为4.8cm2(平均差异为-0.7 cm2,95%可信区间为-1.9到0.5m2,P=0.25)。阿司匹林组中有29例患者发生了40次不良反应,安慰剂组中有27例患者发生了37次不良反应(不良反应发生比值为1.1,95%可信区间为0.7-1.7,P=0.71)。

由此可见,该研究的结果并不支持使用低剂量阿司匹林作为下肢静脉溃疡的辅助治疗。

原始出处:


Andrew Jull, et al. Low dose aspirin as adjuvant treatment for venous leg ulceration: pragmatic, randomised, double blind, placebo controlled trial (Aspirin4VLU). BMJ 2017; 359 doi: https://doi.org/10.1136/bmj.j5157.

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    2018-06-14 gaoxiaoe
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    2018-02-05 fusion
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    2017-11-26 yfjms

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    2017-11-24 changjiu

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