NSAIDs对预防CABG术后心房颤动疗效及主要不良事件的Meta分析  

作　　者：张航[1] 虞敏[1] 冀涛[2] 袁忠祥[1] 

机构地区：[1]南京医科大学附属上海一院临床医学院心脏大血管外科,200080 [2]上海交通大学附属第一人民医院老年医学科,200080

出　　处：《浙江临床医学》2017年第10期1832-1834,共3页Zhejiang Clinical Medical Journal

摘　　要：目的系统评价围手术期使用非甾体类抗炎药对冠状动脉旁路移植术（CABG）术后心房颤动的预防作用及其他主要不良事件发生率。方法检索The Cochrane Library、Medline、EMbase、CBM、CNKI、VIP、万方等数据库，收集非甾体类抗炎药治疗对CABG术后房颤作用的随机对照试验，检索时间截止至2017年4月。由2名研究人员根据纳入和排除标准独立的筛选文献、提取资料并对纳入试验进行质量评价。采用RevMan5．3软件进行Meta分析。结果纳入文献6篇，2468例患者。Meta分析结果显示：围术期，非甾体抗炎药组术后房颤发生率14．9％，对照组术后房颤发生率28．6％，两组差异有统计学意义（P〈0．0001）。对纳入研究术后主要不良事件发生情况进行分析，结果显示：两组心肌梗死、脑卒中、消化道出血和肾功能不全发生率差异均无统计学意义（P〉0．05）。结论围手术期应用NSAIDs~降低CABG术后AF的发生率，不增加术后主要不良事件发生率。Objective To evaluate the efficacy of non-steroidal anti-inflammatory drugs （ NSAIDs ） on the prevention of atrial fibrillation （ AF ） and other complications after coronary artery bypass grafting surgery （ CABG ） . Methods The databases of the Cochrane Library, Medline, EMbase, CBM, CNKI, VIP and WanFang were retrieved for collecting the literature of randomized controlled trials （ RCT ） on NSAIDs preventing atrial fibrillation after CABG from database establishment time to Apr. 2017. Two reviewers independently identified articles according to the inclusion and exclusion criteria, extracted the data, assessed the quality of the included studies. The data were analyzed by Review Manger 5.3. Results There were 6 articles and 2468 patients. The results of Meta analysis showed that the incidence of atrial fibrillation was 14.9% in the NSAID group and 28.6% in the control group in the perioperative period, and the difference between the two groups was statistically significant （ P〈0.0001 ） . The incidence of major adverse events in the study group was analyzed. The results showed that there was no significant difference in the incidence of myocardial infarction, stroke, gastrointestinal bleeding and renal insufficiency between the two groups （ P〉0.05 ） . Conclusion NSAIDs can significantly reduce the incidence of atrial fibrillation after CABG and not increase the rate of other complications.

关 键 词：非甾体抗炎药 冠状动脉血管移植术 心房颤动 META分析 

分 类 号：R654.2[医药卫生—外科学]