Prognostic Evaluation for Oral Squamous Cell Carcinoma:A Novel Method Based on m6A Methylation Regulators

Objective:This study aimed to examine a novel method for prognostic evaluation of patients with oral squamous cell carcinoma(OSCC)based on the expression of heterogeneous nuclear ribonucleoprotein C(HNRNPC),YTH domain-binding protein 2(YTHDF2),and methyltransferase 14(METTL14).Methods:We obtained the RNA sequence and clinical information of OSCC patients from The Cancer Genome Atlas database.An optical method was established by the least absolute shrinkage and selection operator Cox regression algorithm,which was used to calculate the risk score of every sample.In addition,all samples(n=239)were classified into high-risk(n=119)and low-risk(n=120)groups,and the overall survival(OS)time and clinical characteristics were compared between groups.Moreover,bioinformatics analysis was carried out.Gene set enrichment analysis was performed to investigate the signaling pathways of HNRNPC,YTHDF2,and METTL14.Results:The two groups showed significantly different OS time,tumor grades,tumor stages,and pathologic T stages(P<0.05).The receiver operating characteristic analysis identified that our method was effective and it was more accurate than use of age,gender,tumor grade,tumor stage,pathologic T stage,and pathologic N stage in OSCC prognostic prediction.Gene set enrichment analysis revealed that HNRNPC,YTHDF2,and METTL14 were mainly associated with ubiquitin-mediated proteolysis,cell cycle,RNA degradation,and spliceosome signaling pathways.Conclusion:The method based on the expression of HNRNPC,YTHDF2,and METTL14 can predict the prognosis of patients with OSCC independently,and its prognostic value is better than that of clinicopathological characteristic indicators.

Efficacy of Topical Tacrolimus for Erosive Oral Lichen Planus: A Meta-analysis

Objective To assess the efficacy and safety of topical tacrolimus for erosive oral lichen planus(EOLP). Methods Literatures published up to December 2013 were searched from Pub Med, Embase, CENTRAL, Chinese Bio Medical Literature Database(CBM), and System for Information on Grey Literature in Europe(SIGLE). All randomized controlled trials(RCTs) of topical tacrolimus for EOLP which compared with other interventions or a placebo were considered in this Meta-analysis. Two researchers collected data independently. The assessment of methodological quality was based on Cochrane Handbook and the materials were analyzed with the software Revman 5.2.5. The primary outcome measures were the symptoms(e.g. pain, discomfort) complained by patients. The secondary outcome measures included the improvement rate of clinical signs assessed by the investigators and the incidence of adverse effects(e.g. clinical candidiasis). Results A total of 9 RCTs involving 476 patients were finally included. The pooled odds ratio(OR) of clinical improvement for topical tacrolimus vs. topical corticosteroids was 1.19 [95% confidence interval(CI): 0.64-2.22, I2: 44%]. Regarding to 0.1% tacrolimus and 0.03% tacrolimus, the pooled OR were 1.87(95 % CI: 0.60-5.82) and 1.47(95 % CI: 0.14-16.04) respectively in subgroup analysis. No serious adverse events were reported in topical tacrolimus group. Conclusions There was no evidence to support that topical tacrolimus for EOLP was more effective and safer than topical corticosteroids in this Meta-analysis. Clinical assessment criteria should be established and accepted by clinicians and researchers before further RCTs are undertaken.

Pharmacogenomics in oral diseases

The availability of newer technologies for identification and characterization of the human genome has enabled our understanding of the genetic variations in a majority of human diseases.Human genomic sequence varies in less than 1%among the different population group and these differences known as gene polymorphisms are the primary reasons for differences in individuals’response to various drug therapy.Also understanding the genetic changes may enable implementation of targeted therapy,thus providing for effective treatment strategies and minimizing the adverse side effects.Pharmacogenomics is a recent development in the field of personalized medicine which focuses on the genetic determinants of drug response at the levels of entire human genome.It primarily deals with tailoring of drug therapy for every individual based on their genetic make-up and identifying new target in various diseases for drug therapy.While the application of pharmacogenomics in systemic illness is well researched,its role in oral diseases needs documentation.Identifying specific targets in periodontitis,head and neck cancer,infections and genetic disorders can be beneficial in discovery of new drugs.This editorial provides an overview of basics of pharmacoge-nomics,its current role in disease management and its potential role in various head and neck diseases.

Two monitoring methods of oral anticoagulation in patients with mechanical heart valve prostheses:a Meta-analysis

Background Oral anticoagulation with warfarin has become the standard antithrombotic therapy for the patients with mechanical heart valve prothesis.The monitoring method of self-monitoring or self-management is promising to optimize the use of warfarin,but most of the previous studies have included patients with various indications of oral anticoagulant therapy other than valve procedure.This study is intended to evaluate the effects of new monitoring method compared with traditional monitoring in patients with mechanical heart valve prostheses.Methods Relevant literature finished before Dec.2010 were searched through a number of digital database.And then they are pooled by RevMan 4.2 in three fields:rate within the target range,test frequency and occurrence rate of poor events.Results Five randomised control trials with a total of 1662 patients were identified.Pooled estimates showed significant reductions in thromboembolic events(odds ratio 0.55,95%CI 0.35～0.85) and major haemorrhage(0.80,0.54～1.18).Trials of combined self-monitoring and self-adjusted therapy showed significant reductions in thromboembolic events(0.56,0.32～0.98),but not major haemorrhage(1.05,0.60～1.83).No difference was noted in minor haemorrhage and all-cause mortality.All trials reported improvements in the mean proportion of international normalisation ratios in range.Conclusions Self-monitoring can improve the quality of oral anticoagulation therapy in the patients with mechanical.Patients capable of self-monitoring and self-adjusting therapy have fewer thromboembolic events than those who self-monitor alone.However,self-monitoring is not feasible for all patients,and requires identification and education of suitable candidates heart valve prostheses.

Diagnostic value of18F-FDG PET/CT in cervical lymph node metastasis of oral cancer: Meta-analysis

Objective:To evaluate the value of18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) in the diagnosis of cervical lymph node metastasis of oral carcinoma.Methods:China national knowledge infrastructure, Wanfang, Chinese sci-tech journal database, PubMed, EMbase, the Cochrane Library and Web of Science were searched for18F-FDG PET/CT in cervical lymph node metastasis oral cancer. Literature screening, data extraction and literature quality evaluation were carried out independently by two researchers according to the unified classification criteria. Stata13.0 software and Meta-Disc1.4 software were used for meta-analysis.Results: A total of 14 studies with 849 cases of patients with cervical metastasis of oral cancer were included, among which 9 studies were conducted on patients, with a total of 299 patients, and 5 studies were conducted on lymph nodes, with 1965 patients with cervical lymph node proved pathologically. The results of meta analysis showed that18F-FDG PET/CT had good sensitivity and specificity in the diagnosis of cervical lymph node metastasis of oral cancer. The results showed that sensitivity = 0.81 (95% CI: 0.73-0.87), specificity = 0. 90 (95% CI: 0.83-0.94), combined likelihood ratio = 7. 9 (95% CI: 4.9-12.7), negative likelihood ratio = 0. 21 (95% CI: 0.15-0.30), diagnostic odds ratio=37 (95% CI: 20-67), and receiver operating characteristic curve =0.91 (95% CI: 0.89-0.94). Conclusions:18F-FDG PET/CT has high sensitivity and specificity in the diagnosis of cervical lymph node metastasis, and can be used as an important preoperative evaluation method for oral cancer.

口腔健康与老年衰弱相关性的Meta分析

目的采用Meta分析方法对老年人口腔健康与衰弱发生风险之间的相关性进行系统评价。方法计算机检索国内外相关数据库,检索时限:建库至2023年3月12日,按照纳入及排除标准,两名研究者按照独立原则进行文献筛选、资料提取并完成文献质量评价,应用Excel2007进行资料整理,Revman5.3和Stata14.0进行数据分析。结果纳入12篇研究,总样本量21579例,Meta分析结果显示,衰弱组口腔咀嚼功能不及对照组,两组间存在显著性差异(OR=1.65,95%CI:1.02~2.67,P=0.04);衰弱组牙齿缺如程度高于对照组,两组比较差异无统计学意义(OR=1.01,95%CI:0.95~1.07,P=0.79)。亚组分析结果显示:队列研究组异质性低(I2=0,P=0.61),以衰弱指数为评估方法的研究组异质性低(I2=47,P=0.15),但两组结果均无统计学差异。结论现有的结果表明口腔咀嚼功能差可能是老年衰弱发生的危险因素。但是受纳入文献数量和研究方法的影响,此结果需进一步探究。

镁补充改善糖尿病患者血清胰岛素水平的Meta分析

系统评价口服镁补充改善糖尿病患者血清胰岛素水平的效果。采用计算机检索PubMed、EBSCO、The Cochrane Library、CNKI、Web of Science数据库,搜集口服镁补充改善糖尿病患者血清胰岛素水平的相关研究,独立筛查文献、提取资料并评价纳入研究的偏倚风险后采用R studio软件进行Meta分析。亚组分析结果显示,口服镁补充在镁缺乏糖尿病患者中[SMD=-0.29,95%CI(-1.07,0.48),P>0.01]、4~6周补充周期[SMD=-0.74(-1.69,0.20),P>0.01]、250~300 mg/d剂量[SMD=-63(-1.25,0),P<0.01]改善血清胰岛素水平效果更佳,说明口服镁补充对于改善糖尿病患者血清胰岛素水平具有良好的效果。

中药口服联合艾灸治疗溃疡性结肠炎疗效及安全性的Meta分析

目的 基于Meta分析评价中药口服联合艾灸治疗溃疡性结肠炎(UC)的临床疗效及安全性。方法 通过计算机检索中国知网、万方数据知识服务平台、维普网和PubMed,收集中药口服联合艾灸治疗UC的临床随机对照试验,检索时间为建库至2022年11月30日。试验组给予中药口服+艾灸治疗或联合常规西药治疗,对照组给予常规西药治疗。由研究人员对收集的文献进行筛选、资料提取,并使用Review Manager 5.4软件进行Meta分析。结果 最终纳入12篇符合标准的文献,共包含1 055例患者,试验组534例,对照组521例。Meta分析结果显示,试验组总有效率高于对照组[OR=3.83,95%CI(2.65,5.53),P<0.000 01]。根据试验组干预方法的不同进行亚组分析:中药口服+艾灸组总有效率高于对照组[OR=3.80,95%CI(2.47,5.85),P<0.000 01];中药口服+艾灸联合常规西药组总有效率高于对照组[OR=3.91,95%CI(1.93,7.91),P=0.000 2]。试验组复发率低于对照组[OR=0.23,95%CI(0.07,0.71),P=0.01]。试验组不良反应发生率低于对照组[OR=0.39,95%CI(0.19,0.78),P=0.007]。结论 中药口服联合艾灸治疗UC可提高总有效率,降低复发率,且不良反应较少。

通天口服液治疗脑梗死有效性及安全性的meta分析

目的系统评价通天口服液治疗脑梗死的有效性和安全性。方法全面检索中国知网、万方、维普等数据库,搜索通天口服液治疗脑梗死的临床研究,只纳入随机对照试验(RCT)。检索时间从建库至2023年4月。由2名研究者独立完成筛选文献、数据提取及偏倚风险评估。meta分析使用RevMan 5.3软件完成。结果共纳入9个RCT,共计1148例患者。meta分析结果显示,通天口服液治疗脑梗死的总有效率高于对照组,差异有统计学意义(OR=2.18,95%CI:1.53~3.12,P<0.0001);通天口服液治疗急性脑梗死的美国国立卫生研究院卒中量表(NIHSS)评分低于对照组,差异有统计学意义(MD=-1.63,95%CI:-2.20~-1.07,P<0.00001);两组不良事件发生率比较,差异无统计学意义(P>0.05)。结论循证医学分析表明通天口服液治疗脑梗死有效性和安全性较好。

马家柚的研究进展

马家柚是江西省上饶市广丰区地方特色农产品,为红心柚的一个地方品种,被评为中国八大柚类之一,获得了“国家地理标志保护产品”和“农产品地理标志保护”的双重认定,有“江西省酸柚类第一名”之美誉。马家柚内含物质丰富,营养价值高,富含蛋白质、糖分、维生素和矿物质。马家柚还含有大量单糖和番茄红素,具有防癌、抑瘤、保护心血管、预防高血糖、延缓衰老等保健作用。根据已报道的文献,对马家柚的研究进行梳理和总结,从马家柚种质资源和植物学特性、丰产栽培、果实品质和果酒发酵工艺、果皮和柚籽的成分和利用、光合生理、杂交育种和辐射诱变育种、次生代谢及其相关基因表达、叶绿体基因组特征及其密码子偏好性分析、产业发展现状和下一步发展思路等方面进行综述,以期为马家柚种源保护、种质创新、良种繁育、优系利用等工作提供参考。

基于生物信息学构建口腔鳞状细胞癌免疫基因的预后模型

目的旨在构建免疫相关基因(IRGs)的风险预测模型,以预测口腔鳞状细胞癌(OSCC)患者的预后。方法应用生物信息学技术分析OSCC的转录组测序数据,鉴定出差异表达的IRGs(DEIRGs)。通过Cox回归分析构建DEIRGs的风险预测模型,并对其预测能力进行评估。分析该模型与临床病理和免疫细胞浸润的相关性。结果通过比较OSCC和正常样本共鉴定出3634个差异表达基因,其中包括330个DEIRGs(FDR<0.05,|logFC|>1)。单因素Cox回归分析筛选出与预后相关的20个DEIRGs(P<0.05),多因素Cox回归分析筛选出其中15个DEIRGs用于构建风险预测模型。该模型可作为OSCC患者的独立预后因素(P<0.001),预测患者预后的能力具有较高的准确性(AUC=0.732),并与临床分期(t=-3.484,P<0.001)、B细胞(Cor=-0.180,P=0.002)和CD4^(+)T细胞(Cor=-0.127,P=0.026)密切相关。结论基于15个预后相关DEIRGs构建的风险预测模型能够有效地预测OSCC患者的预后,可帮助临床医生为不同风险的OSCC患者选择个性化的治疗策略。

绿茶与口腔癌发病风险的Meta分析

目的:系统评价绿茶与口腔癌发病风险的关系。方法:计算机检索中国期刊全文数据库、万方数据库、维普数据库、中国生物医学文献数据库、The Cochrane Library、PubMed、Web of Science、Embase数据库,检索时限为建库至2023年4月30日,采用RevMan5.4进行Meta分析。结果:共纳入12篇文献,样本量(病例/对照)共有4 259/45 141人。Meta分析结果显示,绿茶摄入是口腔癌发生的保护性因素[OR=0.86,95%CI=(0.78,0.94),P=0.002];摄入量≥500 mL [OR=0.67,95%CI=(0.56,0.80),P<0.000 1]、年限≥20年[OR=0.56,95%CI=(0.42,0.77),P=0.000 3]、浓度适中[OR=0.58,95%CI=(0.48,0.69),P<0.000 01]、温茶[OR=0.40,95%CI=(0.29,0.53),P<0.000 01]是口腔癌发生的保护因素;牛奶与绿茶的饮用呈协同保护作用[OR=0.44,95%CI=(0.35,0.56),P<0.000 01]。结论:绿茶摄入是口腔癌发生的保护因素;牛奶的饮用可与绿茶呈协同作用;建议坚持长期饮茶,每天绿茶摄入量≥500 mL,注意浓度、温度适宜。

蓝芩口服液联合抗菌药物治疗急性扁桃体炎有效性与安全性的系统评价与Meta分析

目的系统评价蓝芩口服液联合抗菌药物治疗急性扁桃体炎的有效性与安全性。方法检索Cochrane Library、PubMed、EMbase、SinoMed、中国知网、万方数据、维普网,收集蓝芩口服液治疗急性扁桃体炎的随机对照试验(RCTs),检索时限从建库至2023年1月1日,采用RevMan 5.3软件进行数据分析。结果5项随机对照试验(RCTs),共计640例急性扁桃体炎患者。Meta分析结果显示,蓝芩口服液联合抗生素治疗急性扁桃体炎,在退热时间(MD=-20.21,95%CI[-25.18,-15.24],P<0.001),咽痛缓解时间(MD=-22.62,95%CI[-30.48,-14.75],P<0.001),有效率(RR=3.07,95%CI[1.92,4.89],P<0.001)方面优于单用抗菌药物,差异具有统计学意义。结论临床试验质量不高,以上结论仍需更多高质量临床试验进一步证明,且需要关注不良反应的问题。

文库构建与基因簇靶向筛选驱动的微生物天然产物高效发现

微生物天然产物作为小分子药物的主要来源,已被广泛应用于医药与农业等领域。随着全球抗生素耐药性与其他公共健康问题的加剧,新结构、新靶点微生物天然产物发现迫在眉睫。大规模(宏)基因组测序揭示微生物蕴含了巨大的生物合成潜力,相继催生了多种不同类型的天然产物挖掘策略。然而,目前仍然缺乏将天然产物合成基因簇与编码产物快速关联的高效方案。近年来,(宏)基因组文库构建在获取批量天然产物合成基因簇方面展现出明显优势,结合高效的基因簇靶向筛选方法,显著加速了新结构天然产物系统发现。本文综述了三类基于(宏)基因组文库构建与靶向筛选驱动天然产物创新发现的策略,主要从克隆载体类型、文库构建方式、基因簇靶向筛选方法等角度进行了阐述,并对Cosmid/Fosmid文库、BAC/PAC文库、FAC/YAC文库等不同文库类型的优缺点及应用范围进行了对比,最后对这些策略的发展前景进行了展望。未来,基于文库构建与基因簇靶向筛选策略将极大驱动不同生境微生物来源的活性天然产物挖掘,预期大量新靶点、新结构天然产物将不断涌现。

蒲地蓝消炎口服液治疗小儿支原体肺炎有效性和安全性的Meta分析

目的:系统评价中成药蒲地蓝消炎口服液联合西药治疗小儿支原体肺炎(MPP)的临床有效性和安全性。方法:通过全面检索关于蒲地蓝消炎口服液联合西药治疗小儿支原体肺炎的随机对照试验(RCT)文献,利用统计软件RevMan5.3提取并分析数据。结果:共纳入13项研究,共包含1313例患者,其中观察组661例,对照组652例。蒲地蓝消炎口服液联合西药治疗小儿支原体肺炎,临床有效率高于单用西药(RR=1.17,95%CI为1.13~1.22,P<0.0001),退热时间(MD=-1.29,95%CI为-1.35~-1.22,P<0.0001),听诊肺部啰音消退时间(MD=-1.77,95%CI为-1.85~-1.69,P<0.0001)及咳嗽症状消退时间(MD=-2.59,95%CI为-2.67~-2.52,P<0.0001)4个方面均优于单用西药。GRADE评价结果显示证据质量以低质量为主。结论:蒲地蓝消炎口服液联合西药优于单独应用西药,且不良反应较少,安全性较好。

药师干预口服抗肿瘤药患者用药依从性的成效分析

目的评价药师干预口服抗肿瘤药物患者用药依从性的成效。方法采用计算机检索PubMed,Web of Science,Embase及中国知网、维普和万方医学数据库中药师对口服抗肿瘤药物患者用药依从性进行干预的相关研究,检索时限为自建库起至2022年4月1日。采用Cochrane偏倚风险评价工具RoB2进行偏倚风险评价,采用RevMan 5.4软件进行Meta分析,无法进行Meta分析的结局指标进行描述性统计。结果共纳入8项随机对照试验(RCT),涉及患者717例。常见的用药依从性干预措施为定期随访、用药教育和咨询。测量方法包括直接评估法和间接评估法,其中直接评估法通过测量血药浓度;间接评估法包括客观评估法(药片计数法和电子监测设备)和主观评估法(患者问卷调查)。4项以患者是否依从用药二分类变量为结局指标的RCT的Meta分析结果显示,药师对口服抗肿瘤药物患者进行药学干预可显著提高其用药依从性[OR=4.59,95%CI(1.09,19.29),P=0.04];亚组分析结果显示,采用主观评估法评估用药依从性的研究中,干预组的用药依从性显著提高[OR=6.84,95%CI(2.84,16.50),P<0.0001]。结论药师积极对口服抗肿瘤药物患者进行药学干预,可提高患者的用药依从性。

老年人口腔衰弱患病率的Meta分析

背景人口老龄化加剧,老年人健康备受关注;口腔衰弱作为老年人衰弱的新表型,其患病率直接关系到老年人生活质量。全面了解老年人口腔衰弱现状,对于制订有效的预防和干预措施具有重要意义。目的系统评价老年人口腔衰弱的患病率。方法计算机检索中国知网(CNKI)、万方数据知识服务平台(Wanfang Data)、维普网(VIP)、中国生物医学文献数据库(CBM)、PubMed、Web of Science、Embase、CINAHL及Cochrane Library数据库中老年人口腔衰弱患病率的相关研究,检索时限为建库至2024-04-19。由2名研究者独立对文献进行筛选、信息提取及质量评价,采用Stata 14.0软件对纳入文献进行Meta分析。结果共纳入19篇横断面研究,总样本量为11776例,偏倚风险质量评分为6~9分,均为中等或高质量。Meta分析结果显示,老年人口腔衰弱的总患病率为29.5%(95%CI=24.1%~35.2%),口腔衰弱前期总患病率为47.9%(95%CI=40.5%~55.4%)。亚组分析结果显示,老年人口腔衰弱患病率随年龄增长递增,使用口腔衰弱指数-8筛查的老年人口腔衰弱患病率更高(P<0.05)。结论老年人口腔衰弱总患病率较高,应重点关注我国高龄老年人的口腔健康状况,选择适宜的筛查评估工具并尽早采取干预措施。

口腔拭子检测对肺结核诊断价值的Meta分析

目的:系统评价口腔拭子检测对肺结核的诊断价值。方法:应用PubMed、Embase、Web of Science、Cochrane Library、中国知网、万方中国科技期刊数据库(Wanfang)、维普数据库(VIP)和中国生物医学文献数据库(CBM),检索建库至2024年4月12日发表的口腔拭子检测肺结核的相关文献,由2名研究者独立进行文献检索、筛选、数据提取和质量评价。采用STATA 16.0软件计算总体和亚组分析的集合敏感度、特异度、阳性似然比、阴性似然比和诊断优势比,利用Deek’s漏斗图评估发表偏倚。结果:共检索出173条文献记录,根据纳入标准和排除标准最终纳入15篇文献。Meta分析结果显示,口腔拭子对肺结核患者诊断的合并敏感度为65.0%(95%CI:54.0%~75.0%),合并特异度为96.0%(95%CI:92.0%~98.0%)。亚组分析显示,在成年肺结核患者中,口腔拭子的诊断敏感度和特异度分别为73.0%(95%CI:64.0%~80.0%)和95.0%(95%CI:83.0%~98.0%)。而舌拭子检测肺结核的敏感度为73.0%(95%CI:63.0%~80.0%),高于脸颊拭子(52.0%,95%CI:34.0%~70.0%)。结论:口腔拭子是诊断肺结核的一种很有前途的替代方法,并且在识别肺结核患者方面,舌拭子比脸颊拭子的敏感度更高。

不同口腔护理对癌症患儿化疗后口腔黏膜炎防治的网状Meta分析

目的:评价6种口腔护理方法对于癌症患儿化疗后口腔黏膜炎防治效果,为防治癌症患儿化疗后口腔黏膜炎及提升其远期生存质量提供依据。方法:检索中英文数据库中关于防治癌症患儿化疗后口腔黏膜炎的随机对照试验,检索时间为建库至2023年5月31日,由2名研究者独立进行检索及资料提取。采用ADDIS1.16.1软件进行网状Meta分析。结果:共纳入文献21篇。Meta分析结果显示,使用醋酸氯己定溶液漱口为降低癌症患儿化疗后口腔黏膜炎发生率的最佳选择;低剂量激光疗法对于降低癌症患儿化疗后口腔黏膜炎发生率、严重口腔黏膜炎发生率,缩短口腔黏膜炎愈合时间三者综合效果最好;涂抹蜂蜜在缩短癌症患儿化疗后口腔黏膜炎愈合时间方面效果最优。结论:不同的口腔护理方法在防治口腔黏膜炎上各具优势,临床上应针对癌症患儿化疗后口腔黏膜炎的不同分期有针对性地选择防治方案,以期有效地预防和快速地治愈其口腔黏膜炎。

窦性心力衰竭患者不同抗栓方案预防栓塞事件的有效性和安全性的Meta分析

目的比较患有心力衰竭(HF)的窦性心律患者使用口服抗凝药(OAC)与抗血小板药(OAP)预防栓塞事件的有效性和安全性。方法从PubMed、Springer、Cochrane图书馆、Elsevier、Wiley、中国知网、万方等电子数据库检索建库至2023年12月关于HF患者使用OAC或OAP的随机对照临床试验(RCTs)中提取人群的卒中、心肌梗死、全因死亡及大出血数据资料后用R语言进行荟萃及偏倚统计分析。结果最终纳入7项大型RCTs(共16823例患者)。分析结果显示,相较于OAP,无论是新型口服抗凝药物(NOAC)还是维生素K拮抗剂(VKA)都可显著降低窦性心律HF患者卒中风险(RR=0.59,95%CI:0.47-0.74,P<0.01,I^(2)=0%),但不降低全因死亡风险(RR=0.87,95%CI:0.75-1.01,P>0.05,I^(2)=65%)。另外,VKA不降低患者心肌梗死的风险(RR=1.08,95%CI:0.80-1.46,P>0.05,I^(2)=0%),却显著增加大出血风险(RR=2.15,95%CI:1.57-2.96,P<0.01,I^(2)=0%)。而NOAC在有效降低患者的心肌梗死风险的情况下(RR=0.78,95%CI:0.65-0.95,P<0.05,I^(2)=0%),不增加大出血风险(RR=1.18,95%CI:0.86-1.62,P>0.05,I^(2)=0%)。结论窦性心律HF患者使用VKA预防栓塞事件有效性与OAP效果相当,但安全性更差,使用NOAC预防栓塞的有效性较OAP效果好,且安全性相当。