Department of Neurology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China.
Chin Med J (Engl). 2017 Dec 20;130(24):2969-2977. doi: 10.4103/0366-6999.220302.
Antiplatelet therapy (APT) was prevalently being used in the prevention of vascular disease, but the influence of prior APT on the prognosis of patients with intracerebral hemorrhage (ICH) remains controversial. This meta-analysis was to explore the effects of prior APT on the prognosis of patients with primary ICH.
PubMed and Embase were searched to identify the eligible studies. The studies comparing the mortality of ICH patients with or without prior APT were included. The quality of these studies was evaluated by the Newcastle-Ottawa quality assessment scale. The adjusted or unadjusted odds ratio (OR) for mortality between ICH patients with and without prior APT were pooled with 95% confidence interval (95% CI) as the effect of this meta-analysis.
Twenty-two studies fulfilled the inclusion criteria and exhibited high qualities. The pooled OR was 1.37 (95% CI: 1.13-1.66, P = 0.001) for univariate analysis and 1.41 (95% CI: 1.05-1.90, P = 0.024) for multivariate analysis. The meta-regression indicated that for each 1-day increase in the time of assessment, the adjusted OR for the mortality of APT patients decreased by 0.0049 (95% CI: 0.0006-0.0091, P = 0.026) as compared to non-APT patients.
Prior APT was associated with high mortality in patients with ICH that might be attributed primarily to its strong effect on early time.
抗血小板治疗（APT）常用于预防血管疾病，但既往 APT 对脑出血（ICH）患者预后的影响仍存在争议。本荟萃分析旨在探讨既往 APT 对原发性 ICH 患者预后的影响。
通过检索 PubMed 和 Embase 数据库，筛选比较既往 APT 的 ICH 患者与无既往 APT 的 ICH 患者死亡率的研究。采用 Newcastle-Ottawa 质量评估量表评估这些研究的质量。采用荟萃分析，将有或无既往 APT 的 ICH 患者死亡率的调整或未调整比值比（OR）及其 95%置信区间（95%CI）作为该荟萃分析的效应量。
共 22 项研究符合纳入标准，且质量较高。单因素分析的汇总 OR 为 1.37（95%CI：1.13-1.66，P = 0.001），多因素分析的汇总 OR 为 1.41（95%CI：1.05-1.90，P = 0.024）。Meta 回归分析表明，与非 APT 患者相比，评估时间每增加 1 天，APT 患者死亡率的调整 OR 降低 0.0049（95%CI：0.0006-0.0091，P = 0.026）。
既往 APT 与 ICH 患者高死亡率相关，这可能主要归因于其对早期的强烈影响。
