急性心肌梗死急诊PCI术后早期应用新活素疗效的Meta分析  

Efficacy of early application of rhbnp after emergency pci in acute myocardial infarction treatment:a meta-analysis

作　　者：巫菲 稂与恒[2] 米睿[2] 李彤[2] WU Fei;LANG Yu-heng;MI Rui;LI Tong(The Third Central Clinical College of Tianjin Medical University, Tianjin 300170, China)

机构地区：[1]天津医科大学第三中心临床学院,天津300170 [2]天津市第三中心医院心脏中心,天津300170

出　　处：《中国循证心血管医学杂志》2016年第6期672-675,共4页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的系统评价急性心肌梗死急诊经皮冠状动脉介入(PCI)术后早期静脉应用新活素的疗效。方法计算机检索Pub Med、Wan Fang Data、CBM、CNKI和VIP数据库关于急性心肌梗死PCI术后早期应用小剂量新活素的随机对照试验(RCT),同时追索纳入文献的参考文献。检索时限为2004~2015年。采用改良Jadad评分方法对文献质量进行评价。统计学分析采用Rev Man 5.3.0。结果共纳入9篇RCT,急性心肌梗死患者565例,其中对照组284例(急诊PCI术后行常规治疗),试验组281例(在对照组的基础上加用新活素)。Meta分析结果显示:脑钠肽改变,试验组大于对照组,差异有统计学意义(SMD=-0.57,95%CI:-0.81^-0.03,P<0.01);左室射血分数改变,试验组大于对照组,差异有统计学意义(MD=1.90,95%CI:0.52~3.29,P<0.01);血浆醛固酮改变,试验组大于对照组,差异有统计学意义(SMD=-1.49,95%CI:-2.67^-0.31,P<0.05);心力衰竭发生率,试验组小于对照组,差异有统计学意义(RR=0.26,95%CI:0.12~0.57,P<0.01)。结论中国人群急性心肌梗死患者行急诊PCI术后早期静脉应用新活素可抑制心室重构,改善心功能,降低心力衰竭发生率,具有较好的临床疗效。Objective Efficacy of early intravenously rhBNP after emergency PCI in acute myocardialinfarction (AMI) treatment was systematically reviewed. Methods Computer-based retrieval of randomizedcontrolled trials (RCTs) on early application of low-dose rhBNP after emergency PCI in AMI treatment wereperformed in PubMed, WanFang Data, CBM, CNKI and VIP, and meanwhile, references included in the resultedliteratures were traced. Articles published between 2004 and 2015 were retrieved. Improved Jadad score was usedfor literature quality assessment and data extraction. RevMan 5.0.25 was used for statistical analysis. Results NineRCTs with 565 AMI patients were included, including 284 patients in control group with routine treatment afteremergency PCI and 281 patients in treatment group used rhBNP on the basis of the control group. Meta-analysisresults showed that change of brain natriuretic peptide was higher in the treatment group than control group (SMD=-0.57, 95%CI: -0.81- -0.03, P<0.01); change of left ventricular ejection fractions was higher in the treatmentgroup than control group (MD=1.90, 95%CI: 0.52-3.29, P<0.01); change of plasma aldosterone was higher inthe treatment group than control group (SMD=-1.49,95%CI: -2.67- -0.31, P<0.05), and recurrence of heartfailure was lower in the treatment group than control group (RR=0.26, 95%CI: 0.12-0.57, P<0.01). ConclusionEarly application of low-dose rhBNP after emergency PCI in Chinese patients with AMI can inhibit ventricularremodeling, improve cardiac function and reduce the incidence of heart failure.

关 键 词：急性心肌梗死 经皮冠状动脉介入术 重组人脑利钠肽 META分析 

分 类 号：R816.2[医药卫生—放射医学]