复方丹参滴丸对急性心肌梗死患者经皮冠状动脉介入术后主要不良心血管事件疗效及改善心室重构的Meta分析  

Effect of Compound Danshen Dripping Pill on MACE and ventricular remodeling improvement in patients with acute myocardial infarction after PCI:a Meta-analysis

作　　者：亓晓萌 柳泽林 陈滢如 魏希进[2] QI Xiaomeng;LIU Zelin;CHEN Yingru;WEI Xijin(Shandong University of Traditional Chinese Medicine,Jinan 250355,Shandong,China;Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Jinan 250011,Shandong,China)

机构地区：[1]山东中医药大学,山东济南250355 [2]山东中医药大学附属医院,山东济南250011

出　　处：《上海中医药大学学报》2022年第6期81-89,共9页Academic Journal of Shanghai University of Traditional Chinese Medicine

基　　金：国家自然科学基金资助项目(81804045)。

摘　　要：目的:应用Meta分析方法评价复方丹参滴丸对急性心肌梗死(AMI)患者经皮冠状动脉介入(PCI)术后主要不良心血管事件(MACE)的疗效及对心室重构的改善作用。方法:计算机检索复方丹参滴丸对AMI患者PCI术后MACE疗效及改善心室重构的随机对照试验(RCT),采用RevMan 5.4软件进行Meta分析及偏倚风险评价,并根据GRADE标准进行证据质量评价。结果:共纳入12篇文献,1 390例患者。Meta分析结果显示,复方丹参滴丸能降低AMI患者PCI术后MACE的总发生率(RR=0.43,95%CI[0.33,0.55],P<0.000 01);改善心室重构方面,复方丹参滴丸可提高AMI患者PCI术后左室射血分数(LVEF;MD=4.77,95%CI[4.04,5.50],P<0.000 01),缩小患者的左室舒张末期内径(LVEDD;MD=-3.64,95%CI[-5.42,-1.86],P<0.000 1)及左室收缩末期内径(LVESD;MD=-3.24,95%CI[-4.88,-1.59],P=0.000 1);不良反应发生率方面,两组间差异无统计学意义(RR=0.73,95%CI[0.34,1.68],P=0.48)。GRADE证据质量评价结果显示,MACE、LVEF、LVEDD为中等质量证据,LVESD、不良反应发生率为低等质量证据。结论:复方丹参滴丸对AMI患者PCI术后MACE的疗效明显,可有效提高患者的心功能,改善心室重构,且未见不良反应增加。由于GRADE证据质量评价结果均为中等或低等质量,故上述结论尚需开展更多高质量研究予以验证。Objective:To evaluate the efficacy of Compound Danshen Dripping Pill on the major adverse cardiovascular events(MACE)and the improvement of ventricular remodeling in patients with acute myocardial infarction(AMI)after percutaneous coronary intervention(PCI)by Meta-analysis method.Methods:The randomized controlled trials(RCT)about the effect of Compound Danshen Dropping Pill on MACE and ventricular remodeling improvement in patients with AMI after PCI were searched by computer. RevMan 5.4software was used for Meta-analysis and bias risk evaluation,and the quality of evidence was evaluated according to GRADE standard.Results:A total of 12 literatures were included,including 1 390 patients. The results of Meta-analysis showed that,Compound Danshen Dripping Pill could reduce the total incidence of MACE in patients with AMI after PCI(RR=0.43,95%CI[0.33,0.55],P<0.000 01);in terms of improving ventricular remodeling,Compound Danshen Dripping Pill could increase the left ventricular ejection fraction(LVEF,MD=4.77,95%CI[4.04,5.50],P<0.000 01),and reduce the left ventricular end-diastolic dimension(LVEDD,MD=-3.64,95%CI[-5.42,-1.86],P<0.000 1)and left ventricular end-systolic diameter(LVESD,MD=-3.24,95%CI[-4.88,-1.59],P=0.000 1)in patients with AMI after PCI;there was no statistically significant difference on the incidence of adverse reactions between the two groups(RR=0.73,95%CI[0.34,1.68],P=0.48). The results of GRADE evidence quality evaluation showed that,MACE,LVEF and LVEDD were the moderate quality evidence,and the LVESD and the incidence of adverse reactions were the low quality evidence.Conclusion:Compound Danshen Dripping Pill has obvious efficacy on the MACE in patients with AMI after PCI,can effectively improve the cardiac function and ventricular remodeling,with no adverse reactions. Since the GRADE evidence quality evaluation results are of medium or low quality,the above conclusions need to be verified by more high quality studies.

关 键 词：急性心肌梗死 经皮冠状动脉介入 复方丹参滴丸 主要不良心血管事件 心室重构 META分析 GRADE评价 

分 类 号：R542.22[医药卫生—心血管疾病]