主动脉球囊反搏辅助治疗急性心肌梗死患者疗效评价  

A meta-analysis on efficacy of intra-aortic balloon pump therapy in patients with acute myocardial infarction

作　　者：张贤锐[1] 苏立[1] 陈少杰[1] 张晓歌[1] 殷跃辉[1] 

机构地区：[1]重庆医科大学附属第二医院心内科,400010

出　　处：《中华心血管病杂志》2013年第5期432-437,共6页Chinese Journal of Cardiology

摘　　要：目的应用荟萃分析的方法探讨临床上使用主动脉球囊反搏（IABP）辅助治疗急性心肌梗死（AMI）的有效性及安全性。方法通过Pubmed、EMBase、Cochrane、中国生物医学文献、万方、维普、中国知网等数据库，检索以使用主动脉球囊反搏辅助治疗急性心肌梗死为主要研究内容的临床随机对照研究（RCT），应用RevMan5．1软件进行统计分析。结果检索筛选到1980--2012年共13个随机对照试验，1958例AMI纳入分析研究，其中接受IABP治疗组970例，未经IABP治疗组（对照组）988例。IABP治疗组30d内的病死率与对照组比较差异无统计学意义（RR=0．77，95％C10．58～1．03，P=0．08）；但在伴有心原性休克亚组中，IABP治疗组30d病死率低于对照组（RR=0．65，95％C10．44～0．97，P=0．04）。IABP治疗组6个月后的病死率明显低于对照组（RR=0．72，95％C10．55～0．94，P=0．02），且亚组分析与总体分析结果相似。IABP组的治疗相关出血事件高于对照组（RR=1．43，95％CI1．16～1．75，P〈0．01）。结论IABP治疗可降低AMI1～6个月的病死率，对伴心原性休克的AMI患者更能早期获益。Objective To analyze the efficacy and safety of intra-aortic balloon pump （IABP） therapy in patients with acute myocardial infarction （AM1） based on the recta-analysis. Methods Eligible published randomized controlled clinical research （RCT） were retrieved in the Pubmed, EMBase, Cochrane, China biological medical literature, Wanfang, VIP and CNKI database from 1980 to April 2, 2012. The analysis was performed with the software of RevMan 5.1. Results Thirteen RCTs with 1958 patients （AMI with IABP therapy, n = 970, without IABP therapy, n = 988 ） were included. The 30-day mortality between the two groups was similar （ RR = 0. 77, 95% CI O. 58 - 1.03, P = 0. 08 ）, but the 30-day mortality in the cardiac shock subgroup was significantly lower in IABP group than in without IABP group （ RR = 0. 65,95 % CI O. 44 -O. 97, P = 0. 04）. The 6-month mortality was significantly lower in IABP group than in without IABP group （ RR = 0. 72, 95% C10. 55 - 0. 94, P = 0. 02）. The incidence of major bleeding was significantly higher in IABP group than in without IABP group （ RR = 1.43, 95% C1 1.16 - 1.75, P 〈 O. O1 ）. Conclusion IABP therapy is effective to reduce earlier mortality post AMI, particularly for patients with cardiac shock.

关 键 词：心肌梗死 主动脉内气囊泵 死亡率 治疗结果 

分 类 号：R542[医药卫生—心血管疾病]