西罗莫司洗脱支架与裸金属支架治疗冠心病的系统评价  

Systematic review of sirolimus-eluting stent versus bare-metal stent in treatment of coronary heart disease

作　　者：刘亮[1] 林国生[1] 李绪勇[1] 郭庆[1] 

机构地区：[1]武汉大学人民医院心内科,湖北武汉430060

出　　处：《临床荟萃》2011年第4期301-306,共6页Clinical Focus

摘　　要：目的比较西罗莫司洗脱支架(SES)与裸金属支架(BMS)治疗冠心病的疗效和安全性。方法计算机检索Cochrane图书馆(2010年第6期)、PubMed、EMBASE、中国生物医学文献数据库,收集2000年1月至2010年6月公开发表的有关SES与BMS治疗冠心病疗效和安全性的随机对照试验(RCT),对文献进行质量评价后,采用RevMan 5.0软件对资料进行分析。结果共纳入9个RCT,SES组与BMS组相比较的Meta分析结果显示,病死率(OR=1.000,P>0.05)及支架血栓发生率(OR=0.860,P>0.05)差异无统计学意义,术后靶病变血运重建(TLR)率(OR=0.250,P<0.01)及主要不良心脏事件(MACE)发生率(OR=0.450,P<0.01)差异有统计学意义,尽管心肌梗死率(OR=0.700,P<0.05)差异有统计学意义,但敏感性分析发现其并不可靠。结论与BMS相比,SES可以降低冠心病患者经皮冠状动脉介入治疗(PCI)术后TLR率和MACE发生率,但不降低病死率及支架血栓发生率。Objective To compare the efficacy and safety of sirolimus-eluting stent（SES） with bare-metal stent（BMS） in treatment of coronary heart disease.Methods We searched the Cochrane Library（Issue 6,2010）,PubMed,EMBASE,CBM to collect randomized controlled trials published between January 2000 and June 2010,which compared the efficacy and safety of sirolimus-eluting stent with bare-metal stent in treatment of coronary heart disease.After evaluating the quality of these studies,we performed Meta-analysis using RevMan 5.0 software.Results Nine randomized controlled trials were included.In SES group versus BMS group,Meta-analysis showed that no significant differences were observed in mortality（OR =1.000,P0.05） and stent thrombosis rate（OR=0.860,P0.05）,significant differences were observed in target lesion revascularization rate（OR=0.250,P0.01） and major adverse cardiac events rate（OR=0.450,P0.01）.The difference of the myocardial infarction rate（OR =0.700,P0.05） was statistically significant,but sensitivity analysis showed that it was not reliable.Conclusion Compared with bare-metal stent,sirolimus-eluting stent can reduce target lesion revascularization rate and major adverse cardiac events rate after PCI in patients with coronary heart disease,but does not decrease the mortality and stent thrombosis rate.

关 键 词：冠状动脉疾病 药物洗脱支架 META分析 

分 类 号：R541.4[医药卫生—心血管疾病]