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Stroke:阿司匹林与蛛网膜下腔出血的风险有关吗?

2017-03-26 xing.T MedSci原创

当前的证据表明,短期(<3个月)使用阿司匹林与aSAH风险增加有关。该分析的局限包括纳入研究的异质性。长期服用阿司匹林降低aSAH风险的作用尚不明确,理想情况下应该通过设计适当的随机对照试验来验证。

最近的研究表明小剂量阿司匹林的使用可以降低动脉瘤性蛛网膜下腔出血(aSAH)的风险。近日,卒中领域权威杂志Stroke上发表了一篇荟萃文章,研究人员旨在基于文献来评估使用阿司匹林和aSAH风险之间的相关性,并且其是否受阿司匹林的使用时间或频率影响。

研究人员对电子数据库进行了检索,时间是从成立之时到2016年9月。对于每一个研究,研究人员采用阿司匹林使用者和非阿司匹林使用者aSAH的风险数据来计算比值比和95%可信区间,并在一个随机效应模型中结合使用方差倒数加权平均–对数比值比。

该分析共纳入了7个研究,研究人员发现在使用时间或频率上阿司匹林使用者和非阿司匹林使用者没有显著差异(比值比为1;95%可信区间为0.81-1.24;P=0.99)。但研究人员发现阿司匹林短期使用(<3个月)与aSAH的风险之间存在显著相关(比值比为1.61;95%可信区间为1.20-2.18;P=0.002)。但阿司匹林使用时间在3到12个月、1到3年和>3年的aSAH风险方面,没有发现显著差异。研究人员发现不频繁使用阿司匹林(≤2次每周)或频繁使用(≥3次每周)与aSAH风险之间均为被观察到显著的相关性。

当前的证据表明,短期(<3个月)使用阿司匹林与aSAH风险增加有关。该分析的局限包括纳入研究的异质性。长期服用阿司匹林降低aSAH风险的作用尚不明确,理想情况下应该通过设计适当的随机对照试验来验证。

原始出处:

Kevin Phan,et al. Aspirin and Risk of Subarachnoid Hemorrhage Systematic Review and Meta-Analysis.Stroke. 2017. https://doi.org/10.1161/STROKEAHA.116.015674

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  2. [GetPortalCommentsPageByObjectIdResponse(id=1654432, encodeId=50e81654432c8, content=<a href='/topic/show?id=5ab788e81d3' target=_blank style='color:#2F92EE;'>#蛛网膜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=88781, encryptionId=5ab788e81d3, topicName=蛛网膜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=396c24497244, createdName=aliceclz, createdTime=Wed Dec 06 12:45:00 CST 2017, time=2017-12-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=184001, encodeId=1c0d184001d3, content=学习一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuOgo3iaicb1Imgk1yIfnvr6oXzibcAFB6puAyNJXbzWhNuLqaFYBVRWjh7rghkvFLPxMAfD5ib3nXwVD/0, createdBy=bed21972958, createdName=wxl882001, createdTime=Fri Mar 31 11:52:22 CST 2017, time=2017-03-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=182854, encodeId=4cc218285454, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo5nmIH5IQqCKjJgSCuicPWUWOUcdqt1ROPnEiaOYN4pSHibDv8la3OxNLalvuvUXn8clpJlrpuyTpckgt9OPkeSSdT/0, createdBy=8fd71930726, createdName=半夏微凉, createdTime=Sun Mar 26 13:16:53 CST 2017, time=2017-03-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=182844, encodeId=820d18284411, content=学习了,值得分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=95, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220115/46bcf39c32de4aa6b45c5f9d66c8ee77/6cb4a20c55bb4b7691122f47747bfca2.jpg, createdBy=9dad1662329, createdName=1ddf0692m34(暂无匿称), createdTime=Sun Mar 26 13:06:30 CST 2017, time=2017-03-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=182812, encodeId=4363182812fe, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6d551998554, createdName=1e1c07bdm01(暂无匿称), createdTime=Sun Mar 26 10:07:14 CST 2017, time=2017-03-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=182811, encodeId=253b182811ca, content=小于3个月的服用阿司匹林与aSAH风险相关。, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzcjoLTEEgkSSQ8pVIiaf4a4INaoMLBV16QEk3dvvBRpicwIwmDGv0jePErJ4aE9ibVBDPtkialQLT9Bs/0, createdBy=04811949400, createdName=邓启付, createdTime=Sun Mar 26 10:02:20 CST 2017, time=2017-03-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=182810, encodeId=2333182810b8, content=什么药用这么久它的所有优缺点都清楚。, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=01bb1684217, createdName=医张生, createdTime=Sun Mar 26 09:58:54 CST 2017, time=2017-03-26, status=1, ipAttribution=)]
    2017-03-31 wxl882001

    学习一下

    0

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    2017-03-26 半夏微凉

    学习了谢谢分享

    0

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    2017-03-26 1ddf0692m34(暂无匿称)

    学习了,值得分享

    0

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    2017-03-26 邓启付

    小于3个月的服用阿司匹林与aSAH风险相关。

    0

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    2017-03-26 医张生

    什么药用这么久它的所有优缺点都清楚。

    0

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