Ann Intern Med:原发性血小板增多症抗血栓治疗的益处和风险!

2017-07-03 xing.T MedSci原创

由此可见,关于ET患者抗血小板治疗的风险-获益比在现有证据的前提下仍然是很不确切的。

原发性血小板增多症患者(ET)在血栓形成和出血上风险均较高。近日,内科学权威杂志Annals of Internal Medicine上发表了一篇荟萃分析文章,研究人员旨在探讨成年ET患者抗血栓治疗的风险和收益。

研究人员检索了多个数据库,包括MEDLINE、EMBASE和Cochrane对照试验登记中心,检索时间至2017年3月4日。研究人员纳入了任何语言发表的和报告了血栓性或出血性事件的进行抗血小板或抗凝治疗的随机或观察性研究。两位评估员独立提取数据,并评估偏倚风险以及确定证据等级。

该荟萃分析未纳入相关的随机试验,24个观察性研究(18对比和6个单组)共计6153例患者,随访了31711例患者每年;大部分被视为高风险的偏倚。大多数接受抗血小板治疗的患者(4527例中的3613例(80%))接受小剂量阿司匹林(50-150mg/d),914例(20%)患者接受大剂量阿司匹林(300-600mg/d),双嘧达莫或其他药物。

总的来说,研究结果是不一致的,且不精确的。未进行抗血小板治疗的患者报告的血栓形成、任何出血和大出血的发生率范围分别从5到110(中位数为20)、从3到39(中位数为8)、从2到53(中位数为6)每1000个病人每年。与未进行治疗的受试者相比,进行抗血小板治疗的患者报告的血栓形成、任何出血和大出血的相对危险度分别为从0.26到3.48(中位数为0.74)、从0.48到11.04(中位数为1.95)、从0.48到5.17(中位数为1.30)。所有结局的证据确定性被评为低或非常低。

由此可见,关于ET患者抗血小板治疗的风险-获益比在现有证据的前提下仍然是很不确切的。

原始出处:


Derek K. Chu,et al. Benefits and Risks of Antithrombotic Therapy in Essential Thrombocythemia: A Systematic Review. Ann Intern Med 2017. http://annals.org/aim/article/2633849/benefits-risks-antithrombotic-therapy-essential-thrombocythemia-systematic-review

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    2019-06-03 liangjixing

    学习了

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  8. 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    2017-07-04 有备才能无患

    关于ET患者抗血小板治疗的风险-获益比在现有证据的前提下仍然是很不确切的。

    0

  9. 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    2017-07-03 清风拂面

    学习了,受益匪浅

    0

  10. 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    2017-07-03 杨利洪

    学习了,提高了

    0

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