阿司匹林联合氯吡格雷应用对血小板聚集率影响的Meta分析

Meta-Analysis of Effect on Platelet Aggregation by Aspirin and Clopidogrel

目的对有关阿司匹林、氯吡格雷对血小板聚集率影响相关文献进行系统评价,为临床用药提供参考。方法查阅国内外已公开发表的有关阿司匹林、氯吡格雷对血小板聚集率影响的临床随机对照试验文献,主要以血小板聚集率为评价指标,以Cochrane协作网的软件RevMan4.2进行Meta分析。结果共有5篇文献符合入选标准,总样本数为198。以二磷酸腺苷为聚集剂,阿司匹林联合氯吡格雷组与阿司匹林组的有效率差值为-26.59,95%可信区间(-38.30,-14.87),位于无效线左侧,具有统计学意义。以胶原蛋白为聚集剂,阿司匹林联合氯吡格雷组与阿司匹林组有效率差值为-16.05,95%可信区间为(-27.37,-4.74)位于无效线的左侧,具有统计学意义。结论阿司匹林联合氯吡格雷对血小板聚集率的影响优于单用阿司匹林,服用氯吡格雷负荷剂量300mg,则影响不大。

Objective A systematic review of the relative references of Aspirin plus Clopidogrel on the platelet aggregation, aimed at providing the reference basis for clinic use of drug. Method Search the clinical randomized controlled trials references of Aspirin plus Clopidogrel on the platelet aggregation published at home and abroad, mainly use platelet aggregation as result indicators, use software RevMan4.2 in Coehrane Cooperation Net to process meta-analysis. Results Total 5 pieces of references paper selected, the total sample number is 198.Use ADP as aggregation agent, the D-value between effective rate of Aspirin plus Clopldogrel group and that of Aspirin group is -26.59,95% confidence interval （-38.30,-14.87） locates on the left side of ineffective line, which has statistical significance. Use Collagen as aggregation agent, the D-value between effective rate of Aspirin plus Clopidogrel group and Aspirin group is -16.05,95% confidenee interval（-27.37,-4.74） locates on the left side of ineffective line, which has statistical significance. Conclusion Compared with Aspirin alone, the effect of Clopidogrel plus Aspirin on the platelet aggregation is more superior, and 300 mg loading-dose of Clopidogrel does not make the difference.