心脏手术伴随心房颤动迷宫术后窦性心律与左心房收缩功能的联合评估:Meta分析  

Combined review on sinus rhythm and left atrial contractility after cardiac surgery accompanied by maze procedure for treating atrial fibrillation:a Meta-analysis

作　　者：马超 韩劲松 Ma Chao;Han Jinsong(Graduate Culture Base,General Hospital of North Theater Command,Jinzhou Medical University,Shenyang 110016,China;不详)

机构地区：[1]锦州医科大学北部战区总医院研究生培养基地,沈阳110016 [2]中国人民解放军北部战区总医院心血管外科,沈阳110016

出　　处：《中国循证心血管医学杂志》2020年第7期798-804,共7页Chinese Journal of Evidence-Based Cardiovascular Medicine

基　　金：辽宁省自然科学基金计划重点项目(20170540977)。

摘　　要：目的综合评价心脏手术伴随心房颤动(房颤)迷宫术后窦性心律与左心房收缩功能(SR-LAC)的联合恢复率。方法计算机检索PubMed/Medline、Web of Science、EMbase数据库,使用相应英文关键词组合搜索收集研究,按照纳入和排除标准筛选文献以及使用Downs and Black清单质量评价后,采用Stata 15.1与R Project 3.4.1结合进行Meta分析。结果最终17项研究(n=1506)纳入Meta分析。心脏手术伴随房颤迷宫术后SR-LAC合并恢复率为65.05%(95%CI:56.56%~73.10%),校正发表偏倚后SR-LAC恢复率为69.30%(95%CI:60.99%~77.02%)。回归分析发现术前较长的房颤(AF)持续时间(β=-0.0040,95%CI:-0.0068^-0.0012,P=0.0057)与心脏手术伴随房颤迷宫术后SR-LAC恢复率降低相关,可能是异质性的潜在因素。结论将SR与LAC功能当作一个整体来联合评估迷宫手术疗效是合理的,术前较长的AF持续时间可能是伴随房颤迷宫手术成功的负性预测因素。Objective To review comprehensively the combined recovery rate of sinus rhythm and left atrial contractility(SR-LAC)after cardiac surgery accompanied by maze procedure for treating atrial fibrillation(AF).Methods The databases of PubMed/Medline,Web of Science and EMbase were retrieved with computer,and the related studies were searched and collected by using corresponding English keyword combinations.The literature was screened according to inclusion and exclusion criteria,and quality was reviewed by using Downs and Black tools.All included studies were given a Meta-analysis by applying Stata 15.1 software and R Project 3.4.1 software.Results There were finally 17 studies(n=1506)included in Meta-analysis.After cardiac surgery accompanied by AF maze procedure,the combined recovery rate of SR-LAC was 65.05%(95%CI:56.56%~73.10%),and was 69.30%after adjusting for publication bias(95%CI:60.99%~77.02%).The results of regression analysis showed that longer duration of AF before operation(β=-0.0040,95%CI:-0.0068^-0.0012,P<0.0057)was correlated to the decrease of SR-LAC recovery rate,which was a possible potential factor for heterogeneity.Conclusion It is reasonable to review the curative effect of maze procedure by regarding SR and LAC as a whole.The longer duration of AF before operation may be a negative predictor for successful cardiac surgery accompanied by maze procedure.

关 键 词：心房颤动 心脏手术 迷宫手术 心房收缩 META分析 

分 类 号：R541.74[医药卫生—心血管疾病]