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Eur Heart J:溶栓治疗对急性肺栓塞患者利弊并存

2014-06-13 高晓方 译 医学论坛网

瑞士一项荟萃分析表明,在急性肺栓塞患者中,溶栓治疗可减少总体死亡、肺栓塞复发和肺栓塞相关性死亡,但亦导致大出血以及致命或颅内出血增多。论文于6月10日在线发表于《欧洲心脏杂志》(Eur Heart J)。研究者检索了相关性数据库,并纳入了在急性肺栓塞患者中对系统溶栓治疗联合抗凝与单纯抗凝进行比较的随机对照试验。评估溶栓治疗在急性肺栓塞患者管理中的风险和获益。 结果显示,共有包括2057例患者的1

瑞士一项荟萃分析表明,在急性肺栓塞患者中,溶栓治疗可减少总体死亡、肺栓塞复发和肺栓塞相关性死亡,但亦导致大出血以及致命或颅内出血增多。论文于6月10日在线发表于《欧洲心脏杂志》(Eur Heart J)。

研究者检索了相关性数据库,并纳入了在急性肺栓塞患者中对系统溶栓治疗联合抗凝与单纯抗凝进行比较的随机对照试验。评估溶栓治疗在急性肺栓塞患者管理中的风险和获益。

结果显示,共有包括2057例患者的15项试验符合纳入标准。与肝素相比,溶栓治疗与总体死亡率显著降低具有相关性(OR;0.59)。排除包括高危肺栓塞的研究之后,上述死亡率降低不再具有统计学显著性(OR;0.64)。

溶栓治疗与死亡或治疗升级复合终点、肺栓塞相关性死亡和肺栓塞复发显著减少具有相关性。但在接受溶栓治疗的患者中,大出血以及致命或颅内出血发生率显著升高。

原始出处:

Marti C1, John G2, Konstantinides S3, Combescure C4, Sanchez O5, Lankeit M3, Meyer G5, Perrier A2.Systemic thrombolytic therapy for acute pulmonary embolism: a systematic review and meta-analysis.Eur Heart J. 2014 Jun 10. pii: ehu218. [Epub ahead of print]

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    2015-01-28 lujian
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    2014-06-15 zhaojie88
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    2014-06-15 lqvr
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    2014-06-15 爆笑小医

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       在近期召开的2012欧洲卒中大会上,奥地利学者公布的一项迄今所发表的最大规模的有关醒后卒中患者溶栓治疗的数据集证明:大量醒后卒中患者可从溶栓治疗中获益,且大出血和死亡发生率并没有增加;溶栓治疗可独立预测早期神经系统的显著改善。   由于当前缺乏醒后卒中患者优化管理和早期转归的数据,迄今绝大多数醒后卒中患者都被排除溶栓治疗。此项研究旨在

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近期的meta分析显示女性急性缺血性卒中患者获得静脉阿替普酶治疗的机会小于男性。为了评估静脉阿替普酶治疗的性别差异,并探求这些差异的原因,荷兰Erasmus MC大学医学中心神经科的Inger de Ridder博士等人进行了一项研究,研究结果在线发表在2013年7月25日的Stroke杂志上。研究结果显示:相比男性,女性患者卒中发病4小时内达到医院的较少,从而获得溶栓治疗的也较少。这种差异可能与

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