希氏束起搏的可行性及安全性Meta分析  

Meta-analysis of the Feasibility and Safety of His Bundle Pacing

作　　者：龙燕 樊光辉[1,2] 李蒋凤 Long Yan;Fan Guanghui;Li Jiangfeng(Hubei University of Chinese Medicine,Wuhan 430000,China;General Hospital of Central Theater Command of PLA,Wuhan 430070,China)

机构地区：[1]湖北中医药大学,湖北武汉430000 [2]中国人民解放军中部战区总医院,湖北武汉430070

出　　处：《湖北民族大学学报（医学版）》2020年第1期25-29,共5页Journal of Hubei Minzu University(Medical Edition)

摘　　要：目的评估希氏束起搏(HBP)的可行性与安全性。方法制定原始文献的纳入标准、排除标准和检索策略,计算机检索中国期刊全文数据库、维普中文科技期刊全文数据库、万方医学、PubMed以及sinomed数据库,提取有关希氏束起搏与传统右心室起搏(RVP)(心尖部或间隔部)临床随机对照试验(RCT),分析文献资料一般特征,评价文献资料质量,提取有效数据后采用RevMan 5.3软件进行Meta分析。结果纳入7篇文献,共有研究对象1255例,其中HBP 534例,RVP 721例。Meta分析结果显示:HBP组QRS时限短于RVP组(WMD=-32.14,95%CI:-50.98^-13.29,P=0.0008);HBP组R波振幅水平低于RVP组(WMD=-5.15,95%CI:-8.46^-1.84,P<0.002);HBP组电极导线阻抗水平低于RVP组(WMD=-53.66,95%CI:-102.95^-4.373,P=0.03);HBP组起搏阈值水平高于RVP组(WMD=0.43,95%CI:0.04~0.82,P=0.03);HBP组可升高患者左室射血分数(LVEF)水平高于RVP组(WMD=6.42,95%CI:3.64~9.19,P<0.00001);HBP组不良反应发生率低于RVP组。结论与RVP相比,HBP同样具有可行性,其有效性及安全性更优,值得临床推广。Objective To assess the feasibility and safety of His bundle pacing(HBP).Methods The inclusion criteria,exclusion criteria and search strategies of the original literature were developed,the CNKI,VIP,Wanfang,Pumed and Sinomed databases were computerized,randomized controlled trials of His bundle pacing and traditional right ventricular pacing(Apex or septum)were extracted,the general characteristics of the literature was analyzed,the quality of the literature was evaluated,and Meta analysis was performed using RevMan 5.3 software after extraction of valid data.Results 7 articles were included,with a total of 1255 subjects,534 HBP cases,and 721 RVP cases.Meta-analysis results showed that His bundle pacing was compared with right ventricular pacing,QRS time limit was shortened(WMD=-32.14,95%CI:-50.98^-13.29,P=0.0008);R wave amplitude level was low(WMD=-5.15,95%CI:-8.46^-1.84,P<0.002);Electrode wire impedance level was low(WMD=-53.66,95%CI:-102.95^-4.373,P=0.03);Pacing threshold level was high(WMD=0.43,95%CI:0.04~0.82,P=0.03);Left ventricular ejection fraction(LVEF)was higher in HBP group than that in RVP group(WMD=6.42,95%CI:3.64~9.19,P<0.00001);The incidence of adverse reactions was lower than RVP.Conclusion Compared with right ventricular pacing,His bundle pacing is also feasible,and its effectiveness and safety are better,which is worthy of clinical promotion.

关 键 词：希氏束起搏 右心室起搏 可行性 安全性 META分析 

分 类 号：R541.7[医药卫生—心血管疾病]