曲美他嗪治疗经皮冠状动脉介入术后心绞痛有效性和安全性的系统评价  

Efficacy and Safety of Trimetazidine in Angina after Percutaneous Coronary Intervention:a Systematic Review

作　　者：卢山[1] 郭自强[2] 刘丽华 LU Shan;GUO Ziqiang;LIU Lihua(Beijing University of Chinese Medicine,Beijing 100029,China)

机构地区：[1]北京中医药大学,北京100029 [2]北京中医药大学东方医院,北京100078

出　　处：《中西医结合心脑血管病杂志》2022年第10期1735-1740,共6页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

摘　　要：目的 系统评价曲美他嗪治疗经皮冠状动脉介入术(PCI)后心绞痛的有效性和安全性。方法 计算机检索中国期刊全文数据库(CNKI)、万方数据知识服务平台(WanFang Data)、维普中文期刊服务平台数据库(VIP)、PubMed、Cochrane Library、Elsevier,搜集曲美他嗪治疗PCI术后心绞痛病人的随机对照试验(RCT),检索时限为2010年1月—2020年12月。按照纳入与排除标准提取数据,应用RevMan 5.4软件对纳入文献进行质量评价与Meta分析。结果 共纳入12篇文献,涉及7573例病人。Meta分析结果显示,与对照组相比,曲美他嗪治疗PCI术后心绞痛能减少心绞痛发作例数[RR=0.51,95%CI(0.38,0.69),P<0.00001],增加左室射血分数[MD=4.85,95%CI(4.00,5.70),P<0.00001],延长6 min步行距离[MD=45.09,95%CI(37.81,52.37),P<0.00001],但在主要心脏不良事件[RR=0.96,95%CI(0.88,1.05),P=0.36]和不良反应[RR=1.00,95%CI(0.94,1.06),P=0.87]方面差异无统计学意义。结论 现有证据显示,曲美他嗪治疗PCI术后心绞痛可以减少心绞痛发作例数,增加左室射血分数,延长6 min步行距离,但在主要心脏不良事件及安全性方面尚不能证明有效。Objective To evaluate the efficacy and safety of trimetazidine in angina after percutaneous coronary intervention(PCI).Methods Randomized controlled trials(RCTs)of trimetazidine treating patients with angina after PCI were collected from China National Knowledge Infrastructure(CNKI),WanFang Data,VIP,PubMed,Cochrane Library,and Elsevier.The retrieval period was from January 2010 to December 2020.Data were extracted according to inclusion and exclusion criteria,and Revman 5.4 software was used to conduct quality assessment and Meta-analysis of the included literatures.Results Twelve papers were included,involving 7573 patients.Meta-analysis results showed that compared with the control group,trimetazidine could reduce angina attacks[RR=0.51,95%CI(0.38,0.69),P<0.00001],increase left ventricular ejection fraction[MD=4.85,95%CI(4.00,5.70),P<0.00001],and increase the 6-minute walking distance[MD=45.09,95%CI(37.81,52.37),P<0.00001].But there was no significant difference in major adverse cardiac events[RR=0.96,95%CI(0.88,1.05),P=0.36]and adverse reactions[RR=1.00,95%CI(0.94,1.06),P=0.87].Conclusion The available evidence suggests that trimetazidine treating patients with angina after PCI can reduce postoperative angina attacks,increase left ventricular ejection fraction,and extend 6-minute walking distance.But there is no evidence to suggest it is effective in major adverse cardiac events and safety.

关 键 词：心绞痛 经皮冠状动脉介入术 曲美他嗪 Meta分析 

分 类 号：R54[医药卫生—心血管疾病]