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JAMA Ophthalmol：新型口服抗凝血药可有效降低患者眼内出血事件

2017-07-10 zhangfan MedSci原创

眼内出血口服抗凝血药华法林
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新型口服抗凝药与华法林相比可减少约1/5的眼内出血风险。心房颤动和静脉血栓栓塞患者有类似的获益。本次研究的结果对视网膜和视网膜下出血风险较高的患者有特殊意义。在围手术期应优先选择新型口服抗凝药物

目前尚不清楚使用新型口服抗凝药物的眼内出血的风险。近日研究人员比较了华法林与新型抗凝药物的眼内出血风险差异。研究人员对截止至2016年8月的学术医疗研究进行系统回顾以及荟萃分析。涉及心房纤颤或静脉血栓栓塞症的新型口服抗凝剂（达比加群相比，利伐沙班，阿哌沙班或依度沙班）与华法林比较，并记录眼内出血事件的3期随机临床试验入选本次研究。眼内出血数据使用逆方差加权汇总，固定效果的荟萃分析。主要终点是新型抗凝血药与华法林相比在眼内出血风险的差异。12个研究涉及102627名患者。相比于华法林，服用新型抗凝血药可相对减少22%的眼内出血风险(rr，0.78；95% CI，0.61-0.99) ，异质性观察无显著差异 (I2=4.8%， P=0.40)。对于口服新抗凝药物的眼内出血风险相对较低的亚组分析表明抗凝治疗指征(P =0.49)以及疾病的类型(P =0.15)无显著性差异。当使用随机效应荟萃分析法得出的结论无显著差异。研究表明，新型口服抗凝药与华法林相比可减少约1/5的眼内出血风险。心房颤动和静脉血栓栓塞患者有类似的获益。本次研究的结果对视网膜和视网膜下出血风险较高的患者有特殊意义。在围手术

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  1. [GetPortalCommentsPageByObjectIdResponse(id=1975697, encodeId=b2fe19e56974f, content=<a href='/topic/show?id=a02b55246af' target=_blank style='color:#2F92EE;'>#抗凝血药#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55246, encryptionId=a02b55246af, topicName=抗凝血药)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f76619, createdName=gj0731, createdTime=Wed Jan 03 17:04:00 CST 2018, time=2018-01-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1541233, encodeId=dc571541233cb, content=<a href='/topic/show?id=5c961e37307' target=_blank style='color:#2F92EE;'>#THA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17373, encryptionId=5c961e37307, topicName=THA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=615b13300589, createdName=1249842em13(暂无昵称), createdTime=Wed Jul 12 02:04:00 CST 2017, time=2017-07-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=220738, encodeId=f8ef220e3862, content=学习了 不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=98, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K0iaeHUsbIzwsociaXY4eY8DryoMrt2gEdB9WBJl32NBRdY2JLRtDPibf3KoIM53fldicMJYbSUWVaXU/0, createdBy=e6fc75818, createdName=maymoon1983, createdTime=Mon Jul 10 14:35:15 CST 2017, time=2017-07-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=220716, encodeId=f44f220e162b, content=阅读了谢谢分享, 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=Mon Jul 10 13:05:10 CST 2017, time=2017-07-10, status=1, ipAttribution=)]
    2018-01-03 gj0731

    #抗凝血药#

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=1975697, encodeId=b2fe19e56974f, content=<a href='/topic/show?id=a02b55246af' target=_blank style='color:#2F92EE;'>#抗凝血药#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55246, encryptionId=a02b55246af, topicName=抗凝血药)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f76619, createdName=gj0731, createdTime=Wed Jan 03 17:04:00 CST 2018, time=2018-01-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1541233, encodeId=dc571541233cb, content=<a href='/topic/show?id=5c961e37307' target=_blank style='color:#2F92EE;'>#THA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17373, encryptionId=5c961e37307, topicName=THA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=615b13300589, createdName=1249842em13(暂无昵称), createdTime=Wed Jul 12 02:04:00 CST 2017, time=2017-07-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=220738, encodeId=f8ef220e3862, content=学习了 不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=98, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K0iaeHUsbIzwsociaXY4eY8DryoMrt2gEdB9WBJl32NBRdY2JLRtDPibf3KoIM53fldicMJYbSUWVaXU/0, createdBy=e6fc75818, createdName=maymoon1983, createdTime=Mon Jul 10 14:35:15 CST 2017, time=2017-07-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=220716, encodeId=f44f220e162b, content=阅读了谢谢分享, 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=Mon Jul 10 13:05:10 CST 2017, time=2017-07-10, status=1, ipAttribution=)]
    2017-07-12 1249842em13(暂无昵称)

    #THA#

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1975697, encodeId=b2fe19e56974f, content=<a href='/topic/show?id=a02b55246af' target=_blank style='color:#2F92EE;'>#抗凝血药#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55246, encryptionId=a02b55246af, topicName=抗凝血药)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f76619, createdName=gj0731, createdTime=Wed Jan 03 17:04:00 CST 2018, time=2018-01-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1541233, encodeId=dc571541233cb, content=<a href='/topic/show?id=5c961e37307' target=_blank style='color:#2F92EE;'>#THA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17373, encryptionId=5c961e37307, topicName=THA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=615b13300589, createdName=1249842em13(暂无昵称), createdTime=Wed Jul 12 02:04:00 CST 2017, time=2017-07-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=220738, encodeId=f8ef220e3862, content=学习了 不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=98, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K0iaeHUsbIzwsociaXY4eY8DryoMrt2gEdB9WBJl32NBRdY2JLRtDPibf3KoIM53fldicMJYbSUWVaXU/0, createdBy=e6fc75818, createdName=maymoon1983, createdTime=Mon Jul 10 14:35:15 CST 2017, time=2017-07-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=220716, encodeId=f44f220e162b, content=阅读了谢谢分享, 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=Mon Jul 10 13:05:10 CST 2017, time=2017-07-10, status=1, ipAttribution=)]
    2017-07-10 maymoon1983

    学习了 不错

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1975697, encodeId=b2fe19e56974f, content=<a href='/topic/show?id=a02b55246af' target=_blank style='color:#2F92EE;'>#抗凝血药#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55246, encryptionId=a02b55246af, topicName=抗凝血药)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f76619, createdName=gj0731, createdTime=Wed Jan 03 17:04:00 CST 2018, time=2018-01-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1541233, encodeId=dc571541233cb, content=<a href='/topic/show?id=5c961e37307' target=_blank style='color:#2F92EE;'>#THA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17373, encryptionId=5c961e37307, topicName=THA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=615b13300589, createdName=1249842em13(暂无昵称), createdTime=Wed Jul 12 02:04:00 CST 2017, time=2017-07-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=220738, encodeId=f8ef220e3862, content=学习了 不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=98, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K0iaeHUsbIzwsociaXY4eY8DryoMrt2gEdB9WBJl32NBRdY2JLRtDPibf3KoIM53fldicMJYbSUWVaXU/0, createdBy=e6fc75818, createdName=maymoon1983, createdTime=Mon Jul 10 14:35:15 CST 2017, time=2017-07-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=220716, encodeId=f44f220e162b, content=阅读了谢谢分享, 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=Mon Jul 10 13:05:10 CST 2017, time=2017-07-10, status=1, ipAttribution=)]
    2017-07-10 半夏微凉

    阅读了谢谢分享

    0

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