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首页> 美国卫生研究院文献>British Medical Journal >Comparison of efficacy and safety of low molecular weight heparins and unfractionated heparin in initial treatment of deep venous thrombosis: a meta-analysis.
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Comparison of efficacy and safety of low molecular weight heparins and unfractionated heparin in initial treatment of deep venous thrombosis: a meta-analysis.

机译：低分子量肝素和普通肝素在深静脉血栓形成初始治疗中的疗效和安全性比较：一项荟萃分析。

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OBJECTIVE--To compare the efficacy and safety of low molecular weight heparins and unfractionated heparin in the initial treatment of deep venous thrombosis for the reduction of recurrent thromboembolic events, death, extension of thrombus, and haemorrhages. DESIGN--Meta-analysis of results from 16 randomised controlled clinical studies. SUBJECTS--2045 patients with established deep venous thrombosis. INTERVENTION--Treatment with low molecular weight heparins or unfractionated heparin. MAIN OUTCOME MEASURES--Incidences of thromboembolic events (deep venous thrombosis or pulmonary embolism, or both); major haemorrhages; total mortality; and extension of thrombus. RESULTS--A significant reduction in the incidence of thrombus extension (common odds ratio 0.51, 95% confidence interval 0.32 to 0.83; P = 0.006) in favour of low molecular weight heparin was observed. Non-significant trends also in favour of the low molecular weight heparins were observed for the recurrence of thromboembolic events (0.66, 0.41 to 1.07; P = 0.09), major haemorrhages (0.65, 0.36 to 1.16; P = 0.15), and total mortality (0.72, 0.46 to 1.4; P = 0.16). CONCLUSIONS--Low molecular weight heparins seem to have a higher benefit to risk ratio than unfractionated heparin in the treatment of venous thrombosis. These results, however, remain to be confirmed by using clinical outcomes in suitably powered clinical trials.
机译：目的比较低分子量肝素和普通肝素在深静脉血栓形成的初始治疗中减少复发血栓栓塞事件，死亡，血栓扩展和出血的有效性和安全性。设计-对16项随机对照临床研究的结果进行元分析。受试者--2045患者已建立深静脉血栓形成。干预-用低分子量肝素或普通肝素进行治疗。主要观察指标-血栓栓塞事件的发生率（深静脉血栓形成或肺栓塞，或两者兼有）；大出血；总死亡率；和血栓的延伸。结果-观察到血栓延长的发生率显着降低（常见比值比为0.51,95％置信区间为0.32至0.83; P = 0.006），有利于低分子量肝素。对于血栓栓塞事件的复发（0.66，0.41至1.07； P = 0.09），严重出血（0.65，0.36至1.16； P = 0.15）和总死亡率，也观察到了低分子量肝素的非显着趋势。 （0.72，0.46至1.4； P = 0.16）。结论-低分子量肝素在静脉血栓形成方面的风险比似乎比普通肝素更高。然而，这些结果仍有待通过在适当的有力临床试验中使用临床结果来证实。

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