药物涂层球囊与药物洗脱支架治疗急性心肌梗死的Meta分析  

Meta-analysis of Drug-coated Balloon and Drug-eluting Stent in the Treatment of Acute Myocardial Infarction

作　　者：严斐斐[1] 黄志伟 蔡小桃 YAN Feifei;HUANG Zhiwei;CAI Xiaotao(Department of Cardiac Uhrasonography,Zhongnan Hospital of Wuhan University,Hubei 430071,China)

机构地区：[1]武汉大学中南医院心脏超声科,430071 [2]武汉大学中南医院心内科,430071

出　　处：《医学研究杂志》2023年第2期143-148,共6页Journal of Medical Research

摘　　要：目的对比药物涂层球囊和药物洗脱支架在接受急诊冠状动脉介入治疗的急性心肌梗死(acute myocardial infarction,AMI)患者中的疗效。方法通过计算机检索万方、中国知网、PubMed、Cochrane Library等数据库,筛选符合条件的临床研究。采用Rev-Man 5.4软件进行统计学分析。结果最终纳入7项研究,共905例患者,包括球囊组418例,支架组487例。Meta分析结果表明,两种治疗方案在主要心血管不良事件(OR=1.00,95%CI:0.55~1.82,P=1.00)、心源性死亡(OR=1.04,95%CI:0.32~3.34,P=0.95)、再发心肌梗死(OR=1.11,95%CI:0.38~3.21,P=0.85)、靶血管血运重建(OR=4.93,95%CI:0.83~29.39,P=0.08)、靶病变血运重建(OR=0.51,95%CI:0.19~1.38,P=0.18)等方面比较差异无统计学意义;球囊组患者晚期管腔丢失优于支架组(MD=-0.22,95%CI:-0.32~-0.12,P<0.001)。结论药物涂层球囊治疗AMI的效果不劣于药物洗脱支架,相比支架置入有更少的晚期管腔丢失。Objective To compare the efficacy of drug-coated balloon(DCB)and drug-eluting stent(DES)in patients with acute myocardial infarction(AMI)undergoing emergency coronary intervention.Methods Data-bases of Wanfang,CNKI,PubMed,the Cochrane Library were searched by computer to screen qualified clinical studies.The statistical analysis was conducted by using Rev-Man 5.4software.Results Seven studies were finally enrolled with a total of 905 patients,of whom 418 patients were assigned to DCB group and 487 patients to DES group.The results of Meta-analysis showed that there were no significant differences in major adverse cardiovascular events(OR=1.00,95%CI:0.55-1.82,P=1.00),cardiac death(OR=1.04,95%CI:0.32-3.34,P=0.95),recurrence of myocardial infarction(OR=1.11,95%CI:0.38-3.21,P=0.85),target vessel revascularization(OR=4.93,95%CI:0.83-29.39,P=0.08)and target lesion revascularization(OR=0.51,95%CI:0.19-1.38,P=0.18).The late lumen loss(LLL)in DCB group was better than that in the DES group(MD=-0.22,95%CI:-0.32--0.12,P<0.001).Conclusion DCB are not inferior to DES in the treatment of AMI,with lesss LLL than DES.

关 键 词：药物涂层球囊 药物洗脱支架 急性心肌梗死 META分析 

分 类 号：R542.22[医药卫生—心血管疾病]