国内无保护左主干病变冠状动脉介入治疗与旁路移植术远期疗效的Meta分析  

Meta-analysis of long-term efficacy on the treatment of percutaneous coronary intervention or coronary artery bypass grafting surgery in unprotected left main coronary artery disease in the domestic

作　　者：王佳旺[1] 吴琼 曹绪芬[1] 徐泽升[1] WANG Jia-wang;WU Qiong;CAO Xu-fen;XU Ze-sheng(Department of No.1 Cardiology,Cangzhou Central Hospital,Cangzhou,Hebei 061001,China)

机构地区：[1]沧州市中心医院心内一科,河北沧州061001

出　　处：《岭南心血管病杂志》2020年第5期515-519,共5页South China Journal of Cardiovascular Diseases

摘　　要：目的采用荟萃分析的方法比较经皮冠状动脉介入(percutaneous coronary intervention,PCI)治疗与冠状动脉旁路移植术(coronary artery bypass graft,CABG)在治疗无保护左主干病变(unprotected left main coronary artery disease,ULMCAD)的远期疗效。方法通过检索2011年1月至2015年12月PubMed、万方数据库、维普数据库、中国知网数据,收集国内公开发表的关于PCI治疗与CABG在ULMCAD长期随访的研究文章。采用Rev Man 5软件对数据进行分析,统计结果为全因死亡,心肌梗死,血管重建,脑卒中,主要不良心脑血管事件。结果共纳入6篇文献,共2859例患者。荟萃分析显示PCI治疗组患者与GABG在组患者随访结果的关系如下:全因死亡(RR=0.74,95%CI:0.43~1.30,Z=1.03,P=0.30)、心肌梗死(RR=1.62,95%CI:1.14~2.32,Z=2.66,P=0.008)、血管重建(RR=2.25,95%CI:1.85~2.73,Z=8.19,P=0.00001)、脑卒中(RR=0.36,95%CI:0.25~0.51,Z=5.65,P<0.00001)、主要不良心脑血管事件(RR=1.30,95%CI:0.94~1.81,Z=1.58,P=0.11)。结论目前国内的研究显示,PCI治疗与CABG治疗ULMCAD患者的远期疗效全因死亡、主要心脑血管事件方面相似。PCI治疗组心肌梗死、血管重建发生率高于CABG,但脑卒中发生率低于CABG组。Objectives To evaluate the long-term outcomes of coronary artery disease patients with unprotected left main coronary artery disease(ULMCAD)receiving percutaneous coronary intervention(PCI)or coronary artery bypass grafting(CABG)in the domestic.Methods By searching PubMed,Weipu,Wanfang,China Knowledge Infrastructure(CNKI)Database on computer from January 2011 to December 2015,the data of randomized control trails of PCI or CABG for ULMCAD were selected.The Rev Man 5 software was used for data analysis.The data included all-cause mortality,myocardial infarction,target vessel revascularization(TVR),cerebrovascular accident,major adverse cardiac and cerebrovascular events(MACCE).Results Six articles including a total of 2859 patients were enrolled for analysis.Meta-analysis of relations of long-term efficacy between PCI group and CABG group were as followed:all-cause mor⁃tality(RR=0.74,95%CI:0.43-1.30,Z=1.03,P=0.30),myocardial infarction(RR=1.62,95%CI:1.14-2.32,Z=2.66,P=0.008),TVR(RR=2.25,95%CI:1.85-2.73,Z=8.19,P=0.00001),cerebrovascular accident(RR=0.36,95%CI:0.25-0.51,Z=5.65,P<0.00001),MACCE(RR=1.30,95%CI:0.94-1.81,Z=1.58,P=0.11).Conclusions The present domestic research shows that all-cause mortality and MACCE are similar between PCI and CABG for ULMCAD.Compared with CABG group,incidences of myocardial infarction and TVR are significantly higher and cerebrovascular accident is significantly lower.

关 键 词：无保护左主干病变 经皮冠状动脉成形术 冠状动脉旁路移植术 META分析 

分 类 号：R541.4[医药卫生—心血管疾病]