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首页> 外文期刊>Gut and Liver >The Role of Acid Suppressants in the Prevention of Anticoagulant-Related Gastrointestinal Bleeding: A Systematic Review and Meta-Analysis
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The Role of Acid Suppressants in the Prevention of Anticoagulant-Related Gastrointestinal Bleeding: A Systematic Review and Meta-Analysis

机译：酸性抑制剂在预防抗凝相关的胃肠道出血中的作用：系统评价和荟萃分析

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Background/Aims Although acid suppressants are widely used for the prevention or treatment of drug-induced upper gastrointestinal bleeding (GIB), evidence regarding the prevention of anticoagulant-related GIB is scarce. The aim of this study was to evaluate the protective effect of acid suppressants against anticoagulant-related GIB. Methods A systematic review was conducted of studies that evaluated the protective effect of acid suppressants against anticoagulant-related GIB found in PubMed, the Cochrane library, Embase, and KoreaMed from the date of database inception to April 2018. Random effect model meta-analyses with sensitivity analyses were conducted. The methodological quality of each included publication was evaluated using the Risk of Bias Assessment Tool for Nonrandomized Studies. Publication bias was assessed. Results In total, six nested case-control or cohort studies were identified and analyzed. Proton-pump inhibitors (PPI) had a protective effect against upper GIB in patients on dicumarinics (risk ratio [RR], 0.56; 95% confidence interval [CI], 0.38 to 0.83; I ~(2), 0%); however, the histamine-2 receptor antagonist did not have the same effect (RR, 0.97; 95% CI, 0.52 to 1.81; I ~(2), 0%). Acid suppressants did not have a protective effect against GIB in patients on dabigatran (hazard ratio, 0.78; 95% CI, 0.44 to 1.37; I ~(2), 81.8%). Conclusions The protective effect of PPIs against dicumarinics-related upper GIB was clear, while there was no evidence supporting the protective effect of acid suppressants against dabigatran-related GIB. However, in the absence of randomized trials demonstrating a lack of bias, solid conclusions cannot be drawn.
机译：背景/目的虽然酸抑制剂广泛用于预防或治疗药物诱导的上胃肠道出血（GIB），但有关预防抗凝血相关的胶质的证据是稀缺的。本研究的目的是评估酸性抑制对抗凝血相关的胶质瘤的保护作用。方法对系统评估进行系统审查，评估了酸抑制剂对抗凝血相关胶虫的保护作用，从数据库成立于2018年4月的数据库成立之日起发现了抗凝血剂相关的GIB。随机效果模型META分析进行敏感性分析。使用BIAS评估工具的风险评估每个包含出版物的方法论质量，用于非扫描研究。评估出版物偏见。结果总共鉴定并分析了六种嵌套病例控制或队列研究。质子泵抑制剂（PPI）对Dicumarinics患者的上GIB进行保护作用（风险比[RR]，0.56; 95％置信区间[CI]，0.38至0.83; I〜（2），0％）;然而，组胺-2受体拮抗剂没有相同的效果（RR，0.97; 95％CI，0.52至1.81; I〜（2），0％）。耐酸抑制剂对达比甙（危害比，0.78; 95％CI，0.44至1.37）的患者对患者对GIB进行保护作用。I〜（2），81.8％）。结论PPI对白细胞相关的上GIB的保护作用很清楚，而没有证据表明酸性抑制剂对达比税醛相关的胶质瘤的保护作用。然而，在没有随机试验的情况下，证明缺乏偏差，不能得出坚实的结论。

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