药物洗脱支架与血管内放射治疗在支架内再狭窄中运用的Meta分析  

Meta-analysis of drug-eluting stents implantation versus vascular brachytherapy for in-stent restenosis

作　　者：方海洋[1] 项建[1] 吴延庆[1] 

机构地区：[1]南昌大学第二附属医院心血管内科,南昌330006

出　　处：《山东大学学报（医学版）》2013年第1期56-63,共8页Journal of Shandong University:Health Sciences

摘　　要：目的比较药物洗脱支架与血管内放射治疗在支架内再狭窄治疗中的疗效及安全性。方法利用文献检索方法收集国内外治疗支架内再狭窄的对比研究,对符合入选条件的文献采用RevMan 5.1软件进行Meta分析。结果入选13篇文献,共纳入病例2 312例,其中药物洗脱支架组1 259例,血管内放射治疗组1 053例。Meta分析显示:药物洗脱支架组再发支架内狭窄(P<0.000 01)、晚期管腔丢失(P<0.000 01)、靶血管血运重建(P=0.03)和主要不良心血管事件(P=0.004)均明显低于血管内放射治疗组。药物洗脱支架组晚期支架血栓发生率和死亡率与血管内放射治疗组相比差异均无统计学意义。结论 Meta分析显示,药物洗脱支架治疗支架内再狭窄在降低支架再次狭窄、减少晚期管腔丢失、靶血管血运重建方面明显优于血管内放射治疗,但不能减少晚期支架血栓形成及降低患者的死亡率。Objective To compare the efficacy and safety of drug-eluting stents （DES） implantation and vascular brachytherapy（VBT） for in-stent restenosis（ISR）. Methods Controlled trials of DES versus VBT for in-stent resteno- sis were collected by literature search method and Meta-analysis was performed by using Review Manager software ver- sion 5.1. Results 13 controlled trials with 2312 patients were included. Of the 2 312 patients, 1 259 were in the DES group and 1053 were in the VBT group. Meta-analysis indicated that, the incidence of binary restenosis （P 〈 0.000 01 ）, late lumen loss （ P 〈 0. 000 01 ）, target-vessel revascularization （TVR） （ P = 0.03 ） and adverse cardiac e- vent （MACE） （P = 0. 004） in the DES group were significantly lower compared with those of the VBT group. There were no significant differences in the incidence and mortality of late stent thrombosis between the two groups. Conclu- sion Drug-eluting stents are markedly superior to VBT for the treatment of ISR in binary restenosis, late lumen loss, TVR reduction, but not in late stent thrombosis and mortality reduction.

关 键 词：药物洗脱支架 血管内放射治疗 支架内再狭窄 META分析 

分 类 号：R541.4[医药卫生—心血管疾病]