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首页> 外文期刊>Canadian journal of gastroenterology >Low-dose acetylsalicylic acid use and the risk of upper gastrointestinal bleeding: A meta-analysis of randomized clinical trials and observational studies.
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Low-dose acetylsalicylic acid use and the risk of upper gastrointestinal bleeding: A meta-analysis of randomized clinical trials and observational studies.

机译：低剂量乙酰水杨酸的使用和上消化道出血的风险：一项随机临床试验和观察性研究的荟萃分析。

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摘要

Low-dose acetylsalicylic acid (LDA, 75 mg?day to 325 mg?day) is recommended for primary and secondary prevention of cardiovascular events, but has been linked to an increased risk of upper gastrointestinal bleeding (UGIB).To analyze the magnitude of effect of LDA use on UGIB risk. Methods: The PubMed and Embase databases were searched for randomized controlled trials (RCTs) reporting UGIB rates in individuals receiving LDA, and observational studies of LDA use in patients with UGIB. Studies were pooled for analysis of UGIB rates.Eighteen studies were included. Seven RCTs reported UGIB rates in individuals randomly assigned to receive LDA (n=22,901) or placebo (n=22,923). Ten case-control studies analyzed LDA use in patients with UGIB (n=10,816) and controls without UGIB (n=30,519); one cohort study reported 207 UGIB cases treated with LDA only. All studies found LDA use to be associated with an increased risk of UGIB. The mean number of extra UGIB cases associated with LDA use in the RCTs was 1.2 per 1000 patients per year (95% CI 0.7 to 1.8). The number needed to harm was 816 (95% CI 560 to 1500) for RCTs and 819 (95% CI 617 to 1119) for observational studies. Meta-analysis of RCT data showed that LDA use was associated with a 50% increase in UGIB risk (OR 1.5 [95% CI 1.2 to 1.8]). UGIB risk was most pronounced in observational studies (OR 3.1 [95% CI 2.5 to 3.7]).LDA use was associated with an increased risk of UGIB.
机译：对于心血管事件的一级和二级预防，建议使用低剂量的乙酰水杨酸（LDA，75 mg /日至325 mg /日），但与上消化道出血（UGIB）的风险增加有关。使用LDA对UGIB风险的影响。方法：在PubMed和Embase数据库中搜索报告接受LDA的人群中UGIB发生率的随机对照试验（RCT），以及对UGIB患者使用LDA的观察性研究。汇总研究以分析UGIB率，包括18项研究。七个随机对照试验报告了随机分配接受LDA（n = 22,901）或安慰剂（n = 22,923）的个体的UGIB率。十项病例对照研究分析了患有UGIB的患者（n = 10,816）和没有UGIB的患者（n = 30,519）的LDA使用情况;一项队列研究报告了仅用LDA治疗的207例UGIB病例。所有研究均发现，使用LDA与UGIB风险增加有关。在RCT中，与LDA使用相关的额外UGIB病例的平均数量为每年每1000名患者1.2次（95％CI为0.7至1.8）。对于RCT，需要伤害的数字是816（95％CI 560至1500），而对于观察研究则需要819（95％CI 617至1119）。对RCT数据的荟萃分析显示，使用LDA与UGIB风险增加50％相关（OR 1.5 [95％CI 1.2至1.8]）。 UGIB风险在观察性研究中最为明显（OR 3.1 [95％CI 2.5至3.7]）。使用LDA会增加UGIB的风险。

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