单线圈和双线圈除颤电极在植入埋藏式转复除颤器患者中除颤有效性比较  

Comparison of defibrillation efficacy of single coil versus dual coil on patients with implantable cardioverter defibrillator

作　　者：李兵[1] 刘晓宇[1] 郑占强[1] 唐培[1] 史威力 张军建[1] 王留义[1] 

机构地区：[1]河南省人民医院,郑州450003

出　　处：《中国实用医刊》2016年第22期5-8,共4页Chinese Journal of Practical Medicine

摘　　要：目的：探讨单线圈和双线圈除颤电极在植入埋藏式转复除颤器（ ICD）患者中的除颤有效性。方法通过 MEDLINE、万方数据库、中国知网数据库，检索关于植入埋藏式转复除颤器应用单、双线圈除颤电极比较为主要内容的临床随机对照研究（RCT），对纳入的研究应用 Revman5.1软件荟萃分析除颤安全性指标：除颤阈值（DFT）、DFT〉15 J 比率和高压阻抗。结果检索截止2016年4月文献80篇，经严格筛选，3个随机对照试验纳入本研究，共有294例患者，其中植入单线圈除颤电极154例，植入双线圈除颤电极140例。三项研究比较发现植入单线圈和双线圈除颤电极 DFT 比较差异未见统计学意义（ WMD =0.79，95% CI：-0.21~1.80，P =0.12）， DFT〉15 J发生率比较差异未见统计学意义（RR =1.72，95% CI：0.85~3.46，P =0.13），两组高压阻抗值比较差异有统计学意义（WMD =19.67，95% CI：8.86~30.49，P =0.004），双线圈明显低于单线圈。结论在植入埋藏式转复除颤器患者中应用单线圈除颤电极除颤术有效性并不劣于双线圈。Objective To compare the defibrillation efficacy of single coil versus dual coil on pa-tients with implantable cardioverter defibrillator（ICD）. Methods A systematic review was performed to iden-tify clinical outcomes of randomized controlled trials（RCT）for implantable cardioverter defibrillator patients receiving single coil or dual coil. MEDLINE,Wanfang data,CNKI were searched. The defibrillation efficacy index included defibrillation threshold（DFT）,the rate of DFT〉15 J and defibrillation resistance. Data anal-ysis were performed with the Revman 5. 1 software. Results Three RCTs with 294 patients（single coil：n =154;dual coi：n =140）were included before April 2016. DFT between the two groups was similar（WMD =0. 79,95%CI：-0. 21 ~ 1. 80,P =0. 12）. The rate of DFT〉15 J had no significant difference between the two groups（RR =1. 72,95% CI：0. 85 ~ 3. 46,P = 0. 13）. But the defibrillation resistance in the dual coil group was significantly lower than that in the single coil group（WMD = 19. 67,95% CI：8. 86 ~ 30. 49,P =0. 004）. Conclusions In the implantation of implantable cardioversion defibrillation,the defibrillation effica-cy of single coil is not inferior to the double coil.

关 键 词：埋藏式转复除颤器 单线圈 双线圈 除颤有效性 

分 类 号：R541.7[医药卫生—心血管疾病]