术前高剂量他汀类药物减少心血管事件有效性的荟萃分析  

Efficacy of high-dose statins administration before surgery on the reduction of cardiovascular events:a meta analysis

作　　者：曹爱霖[1] 钱皎[1] 王卓[1] CAO AiLin;QIAN Jiao;WANG Zhuo(Department of Pharmacy,Changhai Hospital,Second Military Medical University,Shanghai 200433,China)

机构地区：[1]第二军医大学长海医院药学部,上海200433

出　　处：《药学服务与研究》2018年第4期282-287,共6页Pharmaceutical Care and Research

基　　金：上海市卫生计划生育系统重要薄弱学科建设计划项目(2016ZB0303-01)

摘　　要：目的:系统评价亚洲人群在经皮冠状动脉介入(PCI)术前,负荷高剂量他汀类药物治疗急性冠脉综合征减少心血管事件的有效性。方法:应用计算机检索PubMed、EMBase、Cochrane图书馆公开发表的相关随机对照试验,对符合纳入标准的临床研究进行资料提取。使用Cochrane系统评价员手册5.1.0进行质量评价,采用Rev Man 5.3统计软件进行荟萃(meta)分析。结果:最终纳入7项随机对照试验,共1381例入院前未服用他汀类药物的患者,其中试验组(负荷他汀组)689例,对照组692例。试验组的主要心脏不良事件(MACE)发生率显著低于对照组,差异有统计学意义(P<0.001)。同时,PCI术前负荷剂量对围手术期心肌梗死(PMI)发生率有影响,试验组的PMI发生率显著低于对照组,差异有统计学意义(P<0.001)。结论:对于亚洲的急性冠脉综合征患者,PCI术前给予负荷剂量他汀类药物能有效降低患者术后30d的心血管事件发生率。Objective：To evaluate systematically the therapeutic efficacy of short-term high-dose statins administration before surgery in Asian population with acute coronary syndrome（ACS）undergoing percutaneous coronary intervention（PCI）on reducing the incidence of major adverse cardiac events（MACE）.Methods：Published randomized controlled trials（RCTs）were retrieved from PubMed,EMBase and Cochrane Library.Two reviewers independently screened studies according to the exclusion and inclusion criteria and data were extracted.Then,quality evaluation was made by using Cochrane manual 5.1.0.Meta analysis was performed by using Rev Man 5.3 software.Results：A total of 7 RCTs were included,involving 1381 statin-na6 ve Asian patients.Of the 1381 patients,689 patients were given high-dose statins before PCI（the observation group）,and692 patients were given normal or low-dose statins or no drugs before PCI（the control group）.The results of meta analysis showed that the incidence of MACE in the observation group was significantly lower than that in the control group,with statistical significance（P0.01）,and that high dosage of statins before PCI had impact on the incidence of percutaneous myocardial infarction（PMI）in perioperative patients.The incidence of PMI in the observation group was significantly lower than that in the control group,also with statistical significance（P0.01）.Conclusion：In Asian patients with acute coronary syndrome,highdose statins administered before PCI could significantly reduce the incidence of MACE and PMI within 30 days after surgery.

关 键 词：经皮冠状动脉介入 负荷剂量 他汀类药物 急性冠脉综合征 荟萃分析 

分 类 号：R972.6[医药卫生—药品]