合并2型糖尿病行冠脉搭桥手术患者临床预后的Meta分析  

Meta analysis of clinical outcomes in patients with type 2 diabetes undergoing coronary artery bypass grafting

作　　者：巫志国[1] 林利嫦 谭剑[1] 彭洪[1] 

机构地区：[1]江西省萍乡市人民医院麻醉科,江西萍乡337055

出　　处：《中国当代医药》2017年第7期4-10,15,共8页China Modern Medicine

摘　　要：目的应用Meta分析统计合并糖尿病(DM)和非糖尿病(NDM)患者行冠脉搭桥术(CABG)后的死亡率(30 d,1、3、5、10年)和相对危险度(RR)。方法参考相关DM指南制定的入选标准、排除标准,1981年1月~2016年12月检索Pubmed、EMBase、Cochrane library、Sino Med、CNKI、万方、维普数据库,采用Meta分析的方法调查DM与NDM患者行CABG术后(30 d,1、3、5、10年)死亡率和相对危险度(RR)。对命中的文献进行筛选后行质量评价,纳入中高质量的文献并进行资料摘录。采用Rev Man 5.3软件进行统计学分析。结果共获得28篇文献纳入统计分析。DM组和NDM组CABG术后30 d,1、3、5、10年死亡率分别为2.65%、1.92%;5.21%、3.23%;10.15%、5.86%;16.88%、11.20%;23.12%、21.40%。DM组与NDM组比较,术后30 d,1、3、5年的RR(95%CI)升高,分别为1.50(1.34,1.68)、1.88(1.59,2.22)、1.74(1.53,1.99)、1.52(1.34,1.73),差异有统计学意义(P<0.001)。由于I2>70%,未能计算10年死亡率的RR值。结论 DM患者行CABG手术后死亡率(30 d,1、3、5、10年)较NDM人群明显升高。Objective To investigate the mortality （30 days,1 year,3,5,10 years） and relative risk （RR） of patients undergoing coronary artery bypass grafting （CABG） for diabetics mellitus （DM） and non-diabetics mellitus （NDM）.Methods By refering to relevant DM guidelines for inclusion criteria and exclusion criteria,search strategies were made out.Afterwards,Pubmed, EMBase,Cochrane library,SinoMed,CNKI,WanFang ＆ VIP databases were searched for literatures published from January 1981 to December 2016.Subsequently,Meta analysis was used to investigate the mortality and relative risk （RR） of patients with DM and NDM after 30 days,1 year,3,5,10 years.A quality assessment scale was developed to identify each potentially qualified document,moderate and high quality documents were selected for data extraction ＆ meta-analysis.RevManS.3 software was used for statistical analysis.Results 28 eligible documents were identified for pooled analysis.The pooling mortality of 30 days, 1 year,3,5,10 years for DM group and ND M group was 2.65%, 1.92%;5.21%,3.23%; 10.15%,5.86%; 16.88%, 11.20%;23.12%,21A0%.The pooled RR （95% Ci） for mortality rate of DM group versus NDM group were significantly increased at 30 days [1.50 （1.34,1.68）],1 year [1.88 （1.592.22）],3 years [1.74 （1.53,1.99）] and 5 years [1.52 （1.34,1.73）] after CABG （P〈0.01）. 10 years mortality was failed to make pooled analysis due to obvious heterogeneity （F〉70%）.Conclusion The pooling data indicates that CABG may considerably increase mortality risk of 30 days,1 year,3,5,10 years in DM compared to NDM.

关 键 词：冠脉搭桥术 2型糖尿病 预后 META分析 

分 类 号：R815[医药卫生—放射医学]