冠状动脉内应用阿昔单抗对ST段抬高型心肌梗死患者疗效和安全性的Meta分析  

Meta-analysis of therapeutic effect and safety of intracoronary abciximab treatment on patients with ST-elevation myocardial infarction

作　　者：杨幼生 卓朝贵 童随阳 王欣[2] 

机构地区：[1]安陆市普爱医院二内科,湖北安陆市432600 [2]武汉大学人民医院心内科

出　　处：《心血管康复医学杂志》2015年第5期569-575,共7页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的：比较冠状动脉内（IC）应用阿昔单抗与静脉应用（IV）阿昔单抗治疗ST段抬高型心肌梗死（STE-MI）的疗效和安全性。方法：计算机检索PubMed、Coehrane Central Register of Controlled Trials、中国生物医学文献数据库、CNKI全文数据库，收集1993年1月至2014年6月公开发表的有关Ic阿昔单抗和IV阿昔单抗疗效比较的随机对照试验（RCTs），手检可获的参考文献、会议摘要及相关网站资料。对符合要求的RCTs进行资料提取，并采用RevMan5．0软件进行Meta分析。结果：共纳入7项RCTs，Meta分析显示：IC阿昔单抗组再发心肌梗死发生率显著低于IV阿昔单抗组（OR=0．61，95％CI：0．40～0．92，P=0．02）；IC阿昔单抗组与IV阿昔单抗组之间全因死亡率（OR=0．85，95％CI；0．59～1．23，P=0．39）、靶血管再血管化率（OR=0．66，95％CI：0．40～1．09，P=0．10）、大出血发生率（OR=1．00，95％CI：0．68～1．47，P=0．99）均无显著差异。结论：冠脉内应用阿昔单抗能更显著降低sT抬高型心肌梗死患者再发心肌梗死发生察，初步显示了冠脉内应用阿昔单抗疗效的优越性。Objective： To compare therapeutic effects and safety of intracoronary （IC） abciximab and intravenous （IV） abciximab on ST-elevation myocardial infarction （STEMI）. Methods： The databases of PubMed, Cochrane Central Register of Controlled Trials, Chinese Biomedical Literature Database （CBM）and CNKI were retrieved on computers for collecting randomized controlled trials （RCTs） about comparison of therapeutic effects between IC abciximab and IV abciximab published from Jan 1993 to Jun 2014. At the same time, the data included literature, conference abstracts and related websites were retrieved manually. The data of eligible RCTs were extracted and re- ceived recta-analysis using RevMan5.0 software. Results： A total of seven RCTs were enrolled. Meta-analysis indi- cated that incidence rate of recurrent myocardial infarction in IC abciximab group was significantly lower than that of IV abciximab group （OR = 0.61, 95%CI： 0.40~0.92, P = 0.02） ; there were no significant difference in all- cause mortality （OR = 0.85, 95%CI： 0. 59~1.23, P = 0. 39）, target vessel revascularization rate （OR = 0.66, 95% CI： 0. 40~1.09, P = 0.10） and incidence rate of major bleeding （OR = 1.00, 95%CI： 0.68~1.47, P = 0.99） be- tween IC abciximab group and IV abciximab group. Conclusion： The IC abciximab can more significantly reduce in- cidence rate of recurrent myocardial infarction in STEMI patients.

关 键 词：心肌梗死 META分析 阿昔单抗 

分 类 号：R542.22[医药卫生—心血管疾病]