低剂量糖皮质激素对预防冠状动脉搭桥术后新发心房颤动影响的meta分析  

Effect of low-dose glucocorticoids on preventing atrial fibrillation after coronary artery bypass grafting:meta-analysis

作　　者：吕海锋 王国彬[1] 李惠[1] 卢安卫[1] LV Haifeng;WANG Guobin;LI Hui;LU Anwei(Surgical Intensive Care Unit,the First Affiliated Hospital of Zhejiang University,Hangzhou,310003,China)

机构地区：[1]浙江大学医学院附属第一医院外科重症监护病房,杭州310000

出　　处：《临床心血管病杂志》2018年第9期870-875,共6页Journal of Clinical Cardiology

摘　　要：目的:运用meta分析探讨糖皮质激素对预防冠状动脉(冠脉)搭桥术后新发心房颤动的影响。方法:检索Medline/Pubmed、Embase、Elsevier、Sciences online database和Google scholar数据库。搜索2000-01-2017-12符合要求的随机对照试验纳入文献,采用RevMan5.2软件进行meta分析。结果:共搜索到1 204篇相关文献,通过筛选将其中19篇纳入心房颤动分析,10篇纳入感染发生率分析,10篇纳入机械通气时间分析;共2 202例患者,其中1 113例为糖皮质激素组,1 089例为对照组;分析其结果显示,糖皮质激素的应用能降低冠状动脉搭桥术后新发心房颤动的发生率(OR=0.66,95%CI:0.54~0.80;P<0.000 1),但不影响感染发生率(OR=1.25,95%CI:0.74~2.12;P=0.40)和机械通气时间(OR=0.00,95%CI:-0.17~0.18;P=0.99)。结论:对于有冠状动脉搭桥术史的患者,使用低剂量糖皮质激素能降低术后新发心房颤动的发生率,但对术后感染的发生率及机械通气时间无明显影响。Objective：To evaluate the efficacy of glucocorticoids on clinical outcomes of coronary artery bypass grafting.Method：Randomized controlled trials（RCTs）were identified through a systematic literature search of Medline/Pubmed,Embase,Elsevier,Sciences online database and Google scholar（from January 2000 to December2017）.Data were analyzed by the software Review Manager（version 5.2）metafor package.Result：The literature search of all major databases retrieved 1 204 studies.A total of 19 of them were included in the analysis of atrial fibrillation,10 were included in the analysis of the incidence of infection,and 10 were included in the analysis of mechanical ventilation time.The analysis showed that the use of glucocorticoids significantly reduced the incidence of atrial fibrillation（OR=0.66,95%CI：0.54-0.80,P0.000 1）,but did not affect the incidence of infection（OR=1.25,95%CI：0.74-2.12,P=0.40）and mechanical ventilation time（OR=0.00,95%CI：-0.17-0.18,P=0.99）.Conclusion：Glucocorticoids can reduce the postoperative atrial fibrillation after coronary artery bypass grafting.

关 键 词：冠状动脉搭桥术 糖皮质激素 心房颤动 META分析 

分 类 号：R541.7[医药卫生—心血管疾病]