Systematic Review of Risk Factors for Severe Thrombocytopenia or Bleeding Induced by Tirofiban

TAN Ruijuan; WANG Lidan; ZHANG Yuanyuan

doi:10.14009/j.issn.1672-2124.2021.02.020

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Systematic Review of Risk Factors for Severe Thrombocytopenia or Bleeding Induced by Tirofiban

更新时间：2022-10-08

- Systematic Review of Risk Factors for Severe Thrombocytopenia or Bleeding Induced by Tirofiban
- Vol. 21, Issue 2, Pages: 207-212(2021)
- 作者机构：
  
  衡水市人民医院药学部
- 作者简介：
- 基金信息：
- DOI：10.14009/j.issn.1672-2124.2021.02.020
  CLC： R969.3
- Published：2021，
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[1]谭瑞娟,王立丹,张媛媛.替罗非班诱导重度血小板减少或出血危险因素的系统评价[J].中国医院用药评价与分析,2021,21(02):207-212.

TAN Ruijuan, WANG Lidan, ZHANG Yuanyuan. Systematic Review of Risk Factors for Severe Thrombocytopenia or Bleeding Induced by Tirofiban. [J]. 21(2):207-212(2021)
[1]谭瑞娟,王立丹,张媛媛.替罗非班诱导重度血小板减少或出血危险因素的系统评价[J].中国医院用药评价与分析,2021,21(02):207-212. DOI： 10.14009/j.issn.1672-2124.2021.02.020.

TAN Ruijuan, WANG Lidan, ZHANG Yuanyuan. Systematic Review of Risk Factors for Severe Thrombocytopenia or Bleeding Induced by Tirofiban. [J]. 21(2):207-212(2021) DOI： 10.14009/j.issn.1672-2124.2021.02.020.

摘要

目的:系统评价替罗非班诱导重度血小板减少或出血的危险因素。方法:检索PubMed、EMBase、the Cochrane Library、中国期刊全文数据库、中国生物医学文献数据库、万方数据库以及维普数据库中从建库至2020年2月发表的有关替罗非班诱导重度血小板减少或出血危险因素的研究文献

由2名研究员独立按照纳入与排除标准筛选文献、提取资料及评价质量后

采用Rev Man 5.3软件进行荟萃分析（Meta分析）。结果:共纳入10篇文献

其中2篇为外文文献

8篇为中文文献

涉及10 141例患者

共筛选出13种暴露因素。单因素Meta分析结果显示

患者老年（MD=6.23

95%CI=4.58～7.88）、急诊行经皮冠状动脉介入治疗（OR=3.48

95%CI=2.25～5.38）、合并高血压（OR=1.37

95%CI=1.08～1.72）、血小板聚集率降低（MD=-8.91

95%CI=-11.17～-6.66）、血小板计数降低（MD=-21.93

95%CI=-32.81～-11.04）、血清肌酐降低（MD=10.01

95%CI=1.75～18.27）、肌酐清除率降低（MD=-32.16

95%CI=-36.06～-28.25）、肾小球滤过率降低（MD=-15.19

95%CI=-19.11～-11.26）和多种抗凝血药联合应用（OR=0.89

95%CI=0.53～1.25）是替罗非班诱导重度血小板减少或出血的危险因素（P均<0.05）。多因素Meta分析结果显示

老年（>65岁）、合并高血压、急诊行经皮冠状动脉介入治疗和肾小球滤过率降低（<60 ml/min）是替罗非班致重度血小板减少或出血的独立危险因素（P均<0.01）。敏感性分析结果提示

研究结果稳定性较好。结论:患者使用替罗非班时应警惕发生重度血小板减少或出血;对于存在危险因素的患者

应提前进行个体化评估

以减少不良反应的发生。

Abstract

OBJECTIVE: To systematically evaluate the risk factors for severe thrombocytopenia or bleeding induced by tirofiban.METHODS: PubMed

EMBase

the Cochrane Library

CNKI

CBM

Wanfang and VIP database were retrieved to collect the literature of risk factors for severe thrombocytopenia or bleeding induced by tirofiban.The retrieval time was from the establishment of the database to Feb. 2020. Two researchers independently screened the literature according to the inclusion and exclusion criteria

extracted the data and evaluated the quality. RevMan 5. 3 software was used for Meta-analysis. RESULTS: A total of 10 literature were included

including 2 foreign language literature and 8 Chinese literature

and 10 141 patients were enrolled.A total of 13 exposure factors were screened out.The univariate Meta-analysis results showed that patients’ old age（ MD = 6. 23

95% CI = 4. 58-7. 88）

emergency percutaneous coronary intervention（ OR = 3. 48

95%CI = 2. 25-5. 38）

hypertension（ OR = 1. 37

95%CI = 1. 08-1. 72）

reduced platelet aggregation rate（ MD =-8. 91

95% CI =-11. 17--6. 66）

reduced platelet count（ MD =-21. 93

95%CI =-32. 81--11. 04）

reduced serum creatinine（ MD = 10. 01

95% CI = 1. 75-18. 27）

reduced creatinine clearance（ MD =-32. 16

95% CI =-36. 06--28. 25）

reduced glomerular filtration rate（ MD =-15. 19

95% CI =-19. 11--11. 26） and the combined application of multiple anticoagulants（ OR = 0. 89

95%CI = 0. 53-1. 25） were risk factors for severe thrombocytopenia or bleeding induced by tirofiban（ P < 0. 05）. Multivariate Meta-analysis results showed that old age（ >65 years）

hypertension

emergency percutaneous coronary intervention and reduced glomerular filtration rate（ <60 ml/min） were independent risk factors for severe thrombocytopenia or bleeding induced by tirofiban（ P< 0. 01）. The results of sensitivity analysis indicated that the stability of the results was good. CONCLUSIONS:Patients should be alert to severe thrombocytopenia or bleeding when using tirofiban. For patients with risk factors

individualized evaluation should be carried out in advance to reduce the occurrence of adverse drug reactions.

关键词

替罗非班血小板减少出血危险因素Meta分析

Keywords

TirofibanThrombocytopeniaBleedingRisk factorsMeta-analysis

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