急性ST段抬高性心肌梗死经皮冠状动脉成形术后促红细胞生成素疗效的Meta分析  

Comparison of curative effect between erythropoietin and non-erythropoietin in patients with acute ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention:a Meta-analysis

作　　者：李京宴[1] 玛依拉.吾甫尔 时学昆[1] 陈凤辉[1] 程祖亨[1] 

机构地区：[1]新疆医科大学第一附属医院综合心脏内科,乌鲁木齐830054

出　　处：《临床心血管病杂志》2013年第2期116-119,共4页Journal of Clinical Cardiology

摘　　要：目的:收集关于急性ST段抬高性心肌梗死经皮冠状动脉成形术(PCI)后应用促红细胞生成素(EPO)与不用EPO疗效比较的文献,并进行Meta分析。方法:检索Medline(1966-01-2011-12)、PubMed(1980-01-2011-12)、Embase(1990-01-2011-12)、Science(1990-01-2011-12)、Springer(1990-01-2011-12)、CNKI(1994-2011)、万方(1982-2011)等数据库中,有关急性ST段抬高性心肌梗死PCI术后EPO与非EPO疗效比较的随机对照研究,纳入符合标准的文献,提取相关数据进行统计学分析。结果:共6篇文献符合纳入标准,均为英文文献,经改良Jadad评分判定均为高质量研究。Meta分析结果显示,EPO治疗与非EPO治疗在PCI术后第5天与第6个月的变化情况如下:心肌梗死面积变化量的加权均数差(WMD值)为2.03[95%CI:(-0.14,4.20),P=0.07];左室舒张末期容积变化量的WMD值为2.93[95%CI:(2.03,3.83),P<0.01];左室射血分数变化率的WMD值为3.62[95%CI:(2.51,4.73),P<0.01];随访6个月内心血管意外及并发症(死亡、再发心肌梗死、心室颤动、脑卒中等)的WMD值为0.85[95%CI:(0.49,1.46),P=0.55]。结论:急性ST段抬高性心肌梗死PCI术后应用EPO治疗,可减小左室舒张末期容积,增加左室射血分数,改善心功能;但在减少梗死面积和预防心血管意外发生方面,EPO治疗与非EPO治疗无明显差异。Objective：To evaluate the curative effect of erythropoietin and nowerythropoietin in patients with acute ST-segment elevation myocardial infarction （STEMI） undergoing primary percutaneous coronary intervention （PCI）. Method：In Medline （1966-01 -- 2011-12）, Pubmed （1980-01-- 2011-12）, Embase （1990-01-- 2011- 12）, Science （1990-01--2011-12）, Springer （1990-01--2011-12）, CNKI （1994--2011） and Wan Fang （1982-- 2011） database, the randomized controlled study on effect of erythropoietin and non-erythropoietin in patients with acute STEMI undergoing PCI were retrieved. Then we extracted the data and made a Meta-analysis. Result：Six articles were accepted in our Meta-analysis and all of them were high quality researches by modified Jadad Scale. The combined WMD of infarct size was 2.03 [95% CI： （-0.14, 4.20）, P=0.07]. The combined WMD of left ventricular end-diastolic volume （LVEDV） was 2.93 [95%CI： （2.03, 3.83）, P〈0.01]. The combined WMD of left ventricular ejection function （LVEF） was 3. 62[95% CI： （2.51, 4.73）, P〈0.01]. The combined WMD of cardiovascular accident was 0.85 [95 %CI： （0.49, 1.46）, P=0.55]. Conclusion： Erythropoietin can improve cardiac function, decrease LVEDV and increase LVEF in patients with acute STEMI undergoing PCI. However, in the case of decreasing infarct size and preventing cardiovascular accident, erythropoietin treatment and non-erythropoietin treatment has no distinction.

关 键 词：急性ST段抬高性心肌梗死 经皮冠状动脉成形术 促红细胞生成素 META分析 

分 类 号：R542.2[医药卫生—心血管疾病]