主动脉瓣置换对比主动脉根部置换治疗Takayasu动脉炎引起主动脉瓣反流的Meta分析  

Comparison between aortic valve replacement and aortic root replacement in treating Takayasu arteritis-induced aortic regurgitation:a Meta-analysis

作　　者：卢晓峰 李俊玮 王旭[1] 高秉仁[1] 柳德斌[1] Lu Xiaofeng;Li Junwei;Wang Xu;Gao Bingren;Liu Debin(Department of Cardiac and Vascular Surgery,Second Hospital of Lanzhou University,Lanzhou 730030,China;不详)

机构地区：[1]兰州大学第二医院心脏大血管外科,兰州730030

出　　处：《中国循证心血管医学杂志》2021年第12期1438-1442,共5页Chinese Journal of Evidence-Based Cardiovascular Medicine

基　　金：兰州大学第二医院“萃英科技创新”计划项目(CY2017-BJ01);兰州市人才创新创业项目(2017-RC-63)。

摘　　要：目的本文通过Meta分析对比主动脉瓣置换和主动脉根部置换治疗Takayasu动脉炎引起主动脉瓣反流的疗效和预后,为临床实践提供最新依据。方法系统性检索在PubMed、EMbase、Cochrane Library,万方、中国期刊全文数据库(CNKI)和中国生物医学文献(CBM)关于Takayasu动脉炎和主动脉瓣反流的文献,检索截止2020年9月。由两名独立研究者筛选、评估文献质量,采用R软件Meta包进行Meta分析。结果检索结果共计1217篇文献,纳入Meta分析8篇文献,共计237例患者。主动脉瓣置换患者中发生瓣膜脱落/瓣周漏比主动脉根部置换患者更常见(OR=5.85,95%CI:2.00~17.14;P=0.0013,I^(2)=0%)。而假性动脉瘤发生率(OR=2.89,95%CI:0.83~10.02;P=0.0945,I^(2)=0%)、早期死亡率(OR=0.83,95%CI:0.22~3.11;P=0.7879,I^(2)=0%)和晚期死亡率(OR=0.83,95%CI:0.22~3.11;P=0.4904,I^(2)=0%)在两种术式中无明显差异。结论通过合成目前已有的回顾性队列研究数据,结果表明在Takayasu动脉炎造成主动脉瓣反流患者中,主动脉根部置换术在术后瓣膜脱落发生风险明显低于主动脉瓣置换术。然而两种术式在假性动脉瘤发生率、早期死亡率和晚期死亡率上并无显著性差异。目前仍需开展更多高质量临床研究比较这两种术式的疗效和预后。Objective To compare the curative effects and prognosis between aortic valve replacement(AVR)and aortic root replacement(ARR)in treating aortic regurgitation induced by Takayasu arteritis through Meta-analysis,and provide the newest evidence for clinical practice.Methods The databases of PubMed,EMbase,Cochrane Library,WanFang Data,CNKI and CBM were retrieved for screening literature related to Takayasu arteritis and aortic regurgitation until Sept.2020.The data was screened and reviewed by 2 researchers independently,and given a Meta-analysis by using Meta package of R software.Results There were 1217 literature retrieved,8 included into Meta-analysis and 237 involved.Valvular detachment and perivalvular leakage(PVL)were more common in patients received AVR than those in patients received ARR(OR=5.85,95%CI:2.00~17.14,P=0.0013,I^(2)=0%),while incidence rate of pseudoaneurysm(OR=2.89,95%CI:0.83~10.02,P=0.0945,I^(2)=0%),early mortality(OR=0.83,95%CI:0.22~3.11,P=0.7879,I^(2)=0%)and late mortality(OR=0.83,95%CI:0.22-3.11,P=0.4904,I^(2)=0%)had no significant difference.Conclusion Based on current data of retrospective cohort studies,the results indicate that the risk of postoperative valvular detachment is significantly lower in patients received ARR than those in patients received AVR.The incidence rates of pseudoaneurysm,early mortality and late mortality have no significant difference between AVR and ARR.The curative effects and prognosis of AVR and ARR will still need to compare with more clinical studied with high quality.

关 键 词：TAKAYASU动脉炎 主动脉瓣置换 主动脉根部置换 系统评价 META分析 

分 类 号：R543.1[医药卫生—心血管疾病]