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目的评价达比加群酯与华法林对非瓣膜性心房颤动患者的抗凝效果及安全性。方法检索CNKI、VIP、CBM、Pub Med、Em Base、the Cochrane Library数据库,检索时间从2006年1月至2016年5月。收集达比加群酯(试验组)与华法林(对照组)治疗非瓣膜性心房颤动的临床随机对照研究,按Juni评分法进行评价,用Rev Man 5.2软件对相关数据进行Meta分析。结果最终纳入15篇文献,其中10篇英文文献、5篇中文文献。试验组和对照组的脑卒中发生率分别为3.18%和3.99%;动脉栓塞发生率分别为2.43%和3.17%;出血发生率分别为8.46%和8.64%,差异均有统计学意义(P<0.05)。结论达比加群酯可有效地降低非瓣膜性心房颤动患者脑卒中、动脉栓塞及出血发生风险,疗效优于华法林,且安全性更高。
Objective To evaluate the anticoagulant effect and safety of dabigatran etexilate and warfarin in patients with nonvalvular atrial fibrillation. Methods The databases of CNKI, VIP, CBM, Pub Med, Em Base and the Cochrane Library were searched from January 2006 to May 2016. Randomized controlled clinical trial of dabigatran etexilate (warfarin) and warfarin (control group) in the treatment of nonvalvular atrial fibrillation was performed. The data were analyzed by Juni’s score method. Meta-analysis was performed using Rev Man 5.2 software. The results eventually included 15 articles, including 10 English articles and 5 Chinese articles. The incidences of stroke in trial group and control group were 3.18% and 3.99% respectively; the rates of arterial embolism were 2.43% and 3.17% respectively; the incidences of bleeding were 8.46% and 8.64%, respectively, with significant differences (P < 0.05). Conclusion Dabigatran etexilate can effectively reduce the risk of stroke, arterial embolism and hemorrhage in patients with non-valvular atrial fibrillation. The effect is better than warfarin, and the safety is higher.