[Comparison of thrombolysis and anticoagulation in pulmonary thromboembolism: a meta-analysis].
OBJECTIVE
To pool the data of studies about thrombolysis in pulmonary thromboembolism (PTE) and evaluate the efficacy and safety of thrombolysis.


METHODS
The randomized clinical trials (RCTs) that compared the efficacy or safety of thrombolysis and anticoagulation in massive or submassive PTE were chosen from MEDLINE disks from 1966 to May of 2003 and CBM disks from 1978 to May of 2003. A meta-analysis was employed to evaluate the results of the two therapies.


RESULTS
Twelve RCTs including 884 cases were analyzed. Compared with anticoagulation, the total OR of mortality and recurrence of patients with PTE treated with thrombolysis were 0.975 (95% CI 0.504 - 1.886) and 0.653 (95% CI 0.378 - 1.127) respectively, non-significant difference (P > 0.05). The total OR of bleeding in thrombolysis was 2.461 (95% CI 1.636 - 3.702, P < 0.01).


CONCLUSIONS
Compared with anticoagulation, thrombolysis cannot reduce the mortality or recurrence of PTE. Thrombolysis increases the risk of complication of bleeding.
Qin
Zhi-qiang
ZQ
Beijing Chaoyang Hospital-Beijing Institute of Respiratory Medicine, Capital University of Medical Sciences, Beijing 100020, China.
Wang
Chen
C
D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D011655:Pulmonary Embolism / Q000188:drug therapy*; D016032:Randomized Controlled Trials as Topic; D012008:Recurrence; D015912:Thrombolytic Therapy / Q000009:adverse effects
D000925:Anticoagulants