标准剂量与低剂量紫杉醇涂层球囊血管成形术治疗股腘动脉闭塞症的Meta分析  

Meta-analysis of standard-dose versus low-dose paclitaxel-coated balloon angioplasty for femoropopliteal artery occlusive disease

作　　者：周阳 林少芒[1] 萧剑彬[1] 艾文佳[1] 李阳勇[1] 李强[1] 王俊伟[1] 李国林 叶智慧 张智辉[1] ZHOU Yang;LIN Shao-mang;XIAO Jian-bin;AI Wen-jia;LI Yang-yong;LI Qiang;WANG Jun-wei;LI Guo-lin;YE Zhi-hui;ZHANG Zhi-hui(Department of Vascular Surgery,The Second Affiliated Hospital of Guangzhou Medical University,Guangzhou 510220,China)

机构地区：[1]广州医科大学附属第二医院血管外科

出　　处：《中国血管外科杂志（电子版）》2019年第3期183-191,共9页Chinese Journal of Vascular Surgery(Electronic Version)

基　　金：广东省医学科研基金项目(A2012254);广州医科大学博士科研基金项目(2013C48)

摘　　要：目的比较标准剂量紫杉醇涂层球囊(PCB)血管成形术与低剂量PCB血管成形术治疗股腘动脉闭塞性疾病的疗效差异。方法系统性检索MEDLINE、EMBASE和Cochrane数据库截止至2018年10月1日符合纳入标准的随机对照试验(RCT)研究。对入选的RCT的结局指标进行Meta分析,并根据紫杉醇剂量进行亚组分析,结局指标包括术后6个月的远期管腔丢失(LLL)以及术后>50%再狭窄、靶病变血运重建(TLR)、大截肢以及死亡的发生率,以探讨标准剂量PCB与低剂量PCB疗效的差异。结果一共入选了14篇RCT,与低剂量PCB相比,标准剂量PCB更能有效降低术后>50%再狭窄率(P<0.001)和TLR(P<0.05),但两者在术后6个月的LLL方面差异无统计学意义(P>0.05)。结论在股腘动脉闭塞症的治疗中,标准剂量PCB降低术后>50%再狭窄率及TLR的作用均优于低剂量PCB。Objective To compare the efficacy of standard-dose paclitaxel-coated balloon(PCB)angioplasty and low-dose PCB angioplasty for the treatment of femoropopliteal artery(FPA)occlusive disease.Methods We systematically searched MEDLINE,EMBASE,and the Cochrane database to select randomized controlled trials(RCTs)that met the inclusion criteria(until 1 October 2018).Subgroup meta-analyses evaluating late lumen loss(LLL),binary restenosis,target lesion revascularization(TLR),major amputation and mortality were performed according to paclitaxel dose.Results Fourteen RCTs were included.Standard-dose paclitaxel was more effective than low-dose paclitaxel at reducing binary restenosis(P<0.001)and TLR(P<0.05),but there was no significant difference at reducing LLL 6 months after operation(P>0.05).Conclusion Standard-dose paclitaxel is more effective than low-dose paclitaxel at reducing binary restenosis and TLR for FPA occlusive disease.

关 键 词：球囊血管成形术 药物涂层球囊 股腘动脉闭塞症 META分析 

分 类 号：R73[医药卫生—肿瘤]