抗纤维蛋白溶解疗法在动脉瘤性蛛网膜下腔出血中的疗效：一项系统评价和荟萃分析。
The efficacy of antifibrinolytic therapy in aneurysmal subarachnoid hemorrhage: a systematic review and meta-analysis.
作者信息
Fatima Kaneez, Ur Rehman Muhammad Aemaz, Asmar Abyaz, Farooq Hareem, Ahmad Noor-Us-Sabah, Danial Ahmad, Ur Rehman Muhammad Ebaad, Khan Abdullah Ali, Tahir Sidra, Ahmed Umair, Zubair Salman, Khawaja Ayaz
机构信息
Dow University of Health Sciences, Mission Rd, New Labour Colony Nanakwara, Karachi, Sindh, 74200, Pakistan.
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出版信息
Future Sci OA. 2023 May 16;9(6):FSO866. doi: 10.2144/fsoa-2023-0014. eCollection 2023 Jul.
AIM
The efficacy of antifibrinolytics in subarachnoid hemorrhage remains unclear due to conflicting evidence from studies.
MATERIALS & METHODS: Online databases were queried to include randomized controlled trials and propensity matched observational studies. We used Review Manager for the statistical analysis, presenting results as odds ratios with 95% CI.
RESULTS
The 12 shortlisted studies included 3359 patients, of which 1550 (46%) were in the intervention (tranexamic acid) group and 1809 (54%) in the control group. Antifibrinolytic therapy significantly reduced the risk of rebleeding (OR: 0.55; 95% CI: 0.40-0.75; p = 0.0002) with no significant decrease in poor clinical outcome (OR: 1.02; 95% CI: 0.86-1.20; p = 0.85) and all-cause mortality (OR: 0.92; CI: 0.72-1.17; p = 0.50).
CONCLUSION
In patients with subarachnoid hemorrhage, antifibrinolytics reduce the risk of rebleeding without significantly affecting mortality or clinical outcomes.
目的
由于研究证据相互矛盾，抗纤溶药物在蛛网膜下腔出血中的疗效仍不明确。
材料与方法
检索在线数据库，纳入随机对照试验和倾向匹配观察性研究。我们使用Review Manager进行统计分析，结果以比值比及95%置信区间呈现。
结果
入围的12项研究共纳入3359例患者，其中1550例（46%）在干预组（氨甲环酸组），1809例（54%）在对照组。抗纤溶治疗显著降低了再出血风险（比值比：0.55；95%置信区间：0.40 - 0.75；p = 0.0002），而不良临床结局（比值比：1.02；95%置信区间：0.86 - 1.20；p = 0.85）和全因死亡率（比值比：0.92；置信区间：0.72 - 1.17；p = 0.50）无显著降低。
结论
在蛛网膜下腔出血患者中，抗纤溶药物可降低再出血风险，而对死亡率或临床结局无显著影响。
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