颈动脉内膜切除术与脑保护装置下颈动脉血管成形术治疗颈动脉狭窄的Meta分析  

Carotid Endarterectomy Versus Carotid Artery Stenting with Embolic Protection Device for the Treatment of Carotid Stenosis:A Meta-analysis

作　　者：曲志钊 王宏勤[1] 

机构地区：[1]山西医科大学第一临床医学院,山西太原030001

出　　处：《中外医疗》2014年第15期22-24,共3页China & Foreign Medical Treatment

摘　　要：目的：使用Meta分析的方法评价颈动脉内膜切除术（CEA）与脑保护装置（EPD）下颈动脉血管成形术（CAS）治疗颈动脉狭窄的近期疗效和安全性。方法计算机检索2000年1月-2013年12月PubMed、MEDLINE、EMbase、cochrane图书馆、中国期刊全文数据库（CNKI）、万方医学数据库以及中文科技期刊数据库（VIP），收集CEA和CAS＋EPD治疗颈动脉狭窄的随机对照试验，采用RevMan 5.0软件进行Meta分析。结果共纳入6个符合要求的研究，3771例患者，其中CEA组1874例， CAS组1897例。CAS＋EPD组术后30 d脑卒中风险（RR=1.78,95%CI：1.25-2.52，P=0.001）以及脑卒中或死亡联合发生风险（RR=1.62，95%CI：1.19-2.21，P=0.002）均高于CEA组。结论颈动脉血管成形术组治疗颈动脉狭窄的近期疗效与安全性方面未显示优于内膜切除术组。Objective To evaluate the short-term clinical efficacy and safety of carotid endarterectomy（CEA） versus carotid angio-plasty and stenting （CAS） with embolic protection device （EPD） for the treatment of carotid stenosis by meta-analysis method. Methods We searched the electronic databases （PubMed, MEDLINE, EMbase, Cochrane Central Register of Controlled Trials, CNKI, Wanfang and VIP） in order to retrieve randomized controlled trials （RCTs） about comparing CEA and CAS with EPD for the treatment of carotid stenosis. Cochrane collaboration＆#39;s RevMan 5.0 was used for meta-analysis. Results A total of six RCTs, total-ing 3771 patients （1874 patients were randomized to CEA group, 1897 patients were randomized to CAS group） were included in the meta-analysis. There were significantly higher 30-day relative risks after CAS with EPD than after CEA for stroke （RR=1.78, 95%CI：1.25-2.52, P=0.001）and for death or stroke （RR=1.62, 95%CI：1.19-2.21, P=0.002）. Conclusion The available clinical data indicate that the short-term efficacy and safety of CAS with EPD in the treatment of carotid stenosis are not superior to CEA.

关 键 词：颈动脉狭窄 支架 脑保护装置 颈动脉内膜切除术 META分析 

分 类 号：R743[医药卫生—神经病学与精神病学]