论文部分内容阅读
目的:探讨抗凝治疗是否能改善窦性心律的心力衰竭患者预后。方法:通过Pub Med、EMbase、Cochrane Library等数据库收集窦性心律心力衰竭患者使用抗凝治疗的相关研究文献。应用meta分析对所收集的文献进行综合定量评价,主要观察指标包括血栓事件、出血事件和死亡。结果:共纳入文献6篇,累计病例抗凝组2445例,对照组2890例。抗凝组与对照组在全因死亡率方面无显著性差异(OR=1.02,95%CI:0.72-1.38,P=0.73);抗凝组血栓事件风险低于对照组(OR=0.67,95%CI:0.50-0.88,P=0.003),出血事件风险高于对照组(OR=2.17,95%CI:1.55-3.04,P<0.001)。结论 :窦性心律的慢性心力衰竭患者口服抗凝药治疗可以减少血栓事件发生,但增加出血风险,对全因死亡率无影响。
Objective: To investigate whether anticoagulant therapy can improve the prognosis of patients with heart failure of sinus rhythm. Methods: The related literature of anticoagulant therapy was collected from patients with sinus rhythm heart failure by Pub Med, EMbase and Cochrane Library. Meta-analysis was used to conduct a comprehensive and quantitative evaluation of the collected articles. The main observation items included thrombotic events, bleeding events and death. Results: A total of 6 articles were included. There were 2445 cases in the anticoagulant group and 2890 cases in the control group. There was no significant difference in all-cause mortality between the anticoagulant group and the control group (OR = 1.02, 95% CI: 0.72-1.38, P = 0.73). The risk of thrombotic events in the anticoagulant group was lower than that in the control group (OR = 0.67, 95 % CI: 0.50-0.88, P = 0.003). The risk of bleeding was higher than that of the control group (OR = 2.17, 95% CI: 1.55-3.04, P <0.001). CONCLUSIONS: Oral anticoagulant therapy in patients with chronic heart failure of sinus rhythm decreases the incidence of thrombotic events but increases the risk of bleeding without any effect on all-cause mortality.