Efficacy and Safety of Aspirin Combined with Clopidogrel in the Treatment of Progressing Stroke ：A Meta-analysis
- VernacularTitle:阿司匹林联合氯吡格雷治疗进展性脑卒中有效性和安全性的Meta分析
- Author:
Yanzi WU
1
,
2
;
Shan YE
3
;
Fang LIU
1
Author Information
1. Dept. of Pharmacy，Peking University Third Hospital，Beijing 100191，China
2. Dept. of Pharmacology，General Hospital of Eastern Theater Command of PLA，Nanjing 210002，China
3. Dept. of N eurology，Peking University Third Hospital，Beijing 100191，China
- Publication Type:Journal Article
- Keywords:
Aspirin;
Clopidogrel;
Progressing stroke
- From:
China Pharmacy
2020;31(2):227-233
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE：To sy stematically evaluate the efficacy and safety of a spirin combined with clopidogrel in the treatment of progressing stroke. METHODS ：Retrieved from the Cochrane library ，PubMed，Embase，Clinical trials.gov ，CBM， VIP，Wanfang database and CNKI databases ，randomized controlled trials （RCTs）about aspirin combined with clopidogrel （trial group）versus aspirin or clopidogrel alone （control group ）in the treatment of progressing stroke were collected. After literature screening and data extraction ，the quality of literatures were evaluated with bias risk assessment tool recommended by Cochrane system evaluator manual 5.2. Meta-analysis was performed by using Rev Man 5.3 software. RESULTS ：A total of 27 RCTs involving 2 854 patients were enrolled. The results of Meta-analysis showed that response rate of trial group was significantly higher than aspirin group [RR ＝1.31，95％CI（1.26，1.37），P＜0.000 01]；Neurological deficit score （NDS）of trial group was significantly lower than control group [MD ＝－3.80，95％CI（－5.30，－2.30），P＜0.000 01]；National Institutes of Health Stroke Scale Score in trial group was significantly lower than aspirin group [MD ＝－3.72，95％CI（－5.25，－2.20），P＜0.000 01] and clopidogrel group [MD ＝－2.44，95％CI（－4.14，－0.73），P＝0.005]. Results of subgroup analysis showed that NDS score of trial group was significantly lower than control group after 14 d of treatment [MD ＝－2.19，95％CI（－3.11，－1.27），P＜0.000 01]，15 d of treatment [MD ＝－5.73，95％CI（－10.65，－0.81），P＝0.02] and 28 d of treatment [MD ＝－3.45，95％CI（－4.24，－2.67），P＜ 0.000 01]. Compared with trial group ，there was no statistical significance in response rate with clopidogrel group ，the incidence of ADR with clopidogrel group ，the incidence of bleeding event with clopidogrel group ，and mortality with control group （P＞0.05）. CONCLUSIONS：Aspirin combined with clopidogrel in the ； treatment of progressive stroke ，can improve the efficacy and improve neurological deficit symptoms in the short term ，but can not reduce the incidence of ADR or the mortality during E-mail：wuyanzi89@126.com the treatment.
