经皮冠状动脉介入治疗早期与后期应用阿昔单抗疗效及安全性的meta分析  

Efficacy and Safety of Early Versus Late Abciximab for PCI:A Meta Analysis

作　　者：徐兵[1] 陈梅[1] 

机构地区：[1]连云港市第一人民医院药剂科,连云港222001

出　　处：《药学与临床研究》2013年第6期689-693,共5页Pharmaceutical and Clinical Research

摘　　要：目的:系统评价经皮冠状动脉介入治疗(PCI)术前早期与后期应用阿昔单抗的疗效及安全性。方法:计算机检索PubMed、Springer、Ovid、Embase、Cochrance Library、Clinicaltrails.gov和CNKI、万方数据库,检索从建库开始至2013年5月的所有相关临床随机对照研究。同时检索纳入文献的参考文献,并逐个进行质量评价和资料提取。统计学分析采用RevMan5.0软件。结果:共纳入12个随机对照试验,共计2886例患者。Meta分析结果显示,PCI术前早期应用阿昔单抗并不能降低患者近期[OR=0.95,95%CI(0.78,1.17)]及远期[OR=0.71,95%CI(0.47,1.07)]的MACE发生率,亦不能降低患者近期[OR=1.02,95%CI(0.70,1.48)]及远期[OR=0.44,95%CI(0.18,1.06)]的死亡率。但患者术前[OR=2.29,95%CI(1.53,3.43)]及术后[OR=1.59,95%CI(1.10,2.31)]达心肌梗死溶栓治疗(TIMI)3级血流的比例明显增加;患者术后ST-段完全回落的比例也显著增加[OR=1.86,95%CI(1.33,2.59)]。且两组严重出血的发生率没有统计学差异[OR=1.33,95%CI(0.87,2.05)]。结论:现有的资料表明,PCI术前早期应用阿昔单抗虽不能降低患者MACE及死亡的发生率,但可以有效改善患者术前及术后的心肌灌注水平,改善患者心功能,且不增加严重出血的发生率。Objective： To evaluate the efficacy and safety of early versus late abciximab for PCI. Mehtods： Trials were located through electronic searches of the PubMed,Springer,Ovid,Embase,Cochrance Library,Clinicaltrails.gov and CNKI,Wanfang Datebase（from the date of establishment of the databases to May 2013）. Bibliographies of the retrieved articles were also checked. RevMan5.0 Software was used. Results： A total of 12 trials involving 2886 patients were included. The Meta-analysis showed： both the short and long term rates of MACE and mortality were not decreased in early abciximab group. Early abciximab enhanced preand post-procedural TIMI3 flow and complete ST-segment resolution. The rate differences of major bleeding complications were not statistically significant. Conclusions： The limited current evidence shows that although early abciximab could not reduce the rate of MACE and mortality,it effectively improves the preand postprocedural myocardial perfusion levels and heart function without increasing the rate of major bleeding.

关 键 词：经皮冠状动脉介入治疗 阿昔单抗 META分析 

分 类 号：R969.3[医药卫生—药理学]