肝硬化伴门静脉血栓患者中使用新型口服抗凝药效果评价的荟萃分析

Efficacy evaluation of novel oral anticoagulants in patients with cirrhosis accompanied with portal vein thrombosis:a meta-analysis

目的分析在肝硬化伴门静脉血栓(PVT)患者中,使用新型口服抗凝药物(利伐沙班等)的安全性及有效性。方法在PubMed,Web of Science,中国知网、万方、维普检索数据库中,通过主题词和自由词相结合的方式,检索自数据库建立至2021年6月20日发表的临床研究文献。采用随机分组模型在Revman软件进行meta分析。结果PVT再通方面,与传统抗凝药物(如低分子肝素等)相比,新型口服抗凝药再通率更高(OR=13.75,95%CI 3.58~52.90,P=0.0001)。出血方面,新型口服抗凝药相比于传统抗凝药物并不增加出血风险(OR=2.42,95%CI 0.62~9.41,P=0.20)。结论新型口服抗凝药物在PVT再通的发生方面优于传统抗凝药物,在出血的发生方面,2组间差异无统计学意义。

Objective To analyze the safety and efficacy of using novel oral anticoagulants(rivaroxaban and others)in patients with cirrhosis accompanied with portal vein thrombosis(PVT).Methods Clinical research literature published from the establishment of the database to June 20,2021,was retrieved from PubMed,Web of Science,CNKI,Wanfang,and Weipu databases by combining subject terms and free words.RevMan software was used for the random group meta-analysis model.Results In terms of PVT recanalization,the novel oral anticoagulants(such as low molecular weight heparin and others)had a higher recanalization rate than traditional anticoagulants(OR=13.75,95%CI 3.58-52.9,P=0.0001).In terms of bleeding,the novel oral anticoagulants did not increase the risk of bleeding compared with traditional anticoagulants(OR=2.42,95%CI 0.62-9.41,P=0.20).Conclusion The novel oral anticoagulant drugs are superior to traditional anticoagulants in terms of the occurrence of PVT recanalization;however,there is no statistically significant difference in terms of the occurrence of bleeding between the two groups.