主动脉内气囊泵辅助治疗不伴有心源性休克的高风险经皮冠状动脉介入手术有效性的Meta分析  

Effectiveness of intra-aortic balloon pump in high-risk percutaneous coronary interventions without cardiogenic shock:A Meta-Analysis

作　　者：赵培新[1] 马依彤[1] 于子翔[1] 叶远征[1] 马翔[1] 

机构地区：[1]新疆医科大学第一附属医院冠心病科,乌鲁木齐830054

出　　处：《新疆医科大学学报》2014年第5期584-590,共7页Journal of Xinjiang Medical University

基　　金：新疆维吾尔自治区科技支疆项目(2013911118)

摘　　要：目的：荟萃分析主动脉内气囊泵辅助治疗不伴有心源性休克的高风险冠状动脉介入术的临床疗效。方法计算机检索Pubmed、Cochrane图书馆、Medline、Embase、万方数据库，检索以主动脉球囊反搏辅助治疗高风险经皮冠状动脉介入术为主要内容的临床随机对照试验（RCT），检索时限为1990年1月-2013年4月，严格按照纳入标准筛选文献、提取资料和评价质量后，采用RevMan 5．1软件进行统计学分析。结果共纳入7篇文献（6个研究）1595例患者，其中接受主动脉球囊反搏（IABP）治疗组784例，未经 IABP治疗组（对照组）811例。Meta分析结果显示：IABP治疗组30 d的病死率与对照组比较差异无统计学意义（RR＝0．73，95％CI＝0．43～1．23，P＝0．24），IABP治疗组6个月的病死率与对照组比较差异无统计学意义（RR ＝0．69，95％CI ＝0．49～1．05，P ＝0．09），IABP治疗组再次发生心肌梗死事件概率与对照组比较差异无统计学意义（RR ＝1．09，95％CI ＝0．77～1．53，P ＝0．63），IABP治疗组再次发生心肌缺血概率与对照组比较差异无统计学意义（RR＝1．04，95％CI＝0．71～1．51，P ＝0．85）。IABP组的治疗相关出血事件高于对照组（RR＝1．44，95％CI＝1．16～1．79，P ＝0．001）。结论与单纯经皮冠状动脉介入手术病人相比，在高风险的经皮冠状动脉介入患者中使用主动脉球囊反搏并不会降低其心梗后30 d病死率、6个月病死率及主要不良心血管事件发病率。Objective A systematic review for the randomized controlled trial was performed to evaluate the effectiveness of intra aortic balloon pump adj uvant treatment in high-risk percutaneous coronary interven-tion without cardiogenic shock.Methods We searched Pubmed,Cochrane Library （2013 No 1）,CNKI, Medline,Embase,Wanfang database,and took the treatment of IABP in high-risk percutaneous coronary intervention as the main content of randomized controlled trials （RCT）.The retrieval time was from Janu-ary 1990 to April 1990.The quality of included studies was critically evaluated.Data analyses were per-formed with the RevMan5 .1 software.Results Six randomized controlled trials with 1 5 9 5 patients were included and then divided into IABP treatment group （n=784）,without IABP treatment group （control group）（n=811）.The 30-day mortality of the difference between treatment group and control group was not statistically significant （RR= 0.73,95%CI=0.43 ~ 1.23,P =0.24）.The 6-month mortality of the difference between treatment group and control group was not statistically significant （RR=0.69,95%CI=0.49~1.05,P=0.09）.The recurrence of myocardial infarction,the difference between treatment group and control group was not statistically significant （RR=1.09,95%CI 0.77~1.53,P =0.63）.The recur-rence of myocardial ischemia of the difference between treatment group and control group was not statisti-cally significant （RR=1.04,95%CI=0.71~1.51,P=0.85）.The incidence of major bleeding was signifi-cantly higher in IABP group than in without IABP group （RR=1.44,95%CI=1.16~1.79,P =0.001）. Conclusion IABP therapy can not reduce high-risk patients undergoing PCI earlier mortality post AMI and the incidence of maj or adverse cardiovascular events.

关 键 词：主动脉内气囊泵 高风险的经皮冠状动脉介入术 心肌梗死 随机对照试验 META分析 

分 类 号：R542.22[医药卫生—心血管疾病]