心房颤动对使用MitraClip治疗二尖瓣反流术后影响的Meta分析  

Meta-analysis of the Effect of Atrial Fibrillation on the Outcomes of Mitral Regurgitation Using MitraClip

作　　者：蔡小桃 张超[1] 严斐斐[2] CAI Xiaotao;ZHANG Chao;YAN Feifei(Department of Cardiology,Zhongnan Hospital of Wuhan University,Hubei 430071,China)

机构地区：[1]武汉大学中南医院心血管内科,430071 [2]武汉大学中南医院心血管超声医学科,430071

出　　处：《医学研究杂志》2023年第4期106-111,共6页Journal of Medical Research

摘　　要：目的 评价心房颤动对使用MitraClip缘对缘修复术治疗二尖瓣反流术后的影响。方法 通过计算机检索PubMed、Cochrane Library、中国知网(CNKI)、万方数据知识服务平台等数据库,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8篇研究,共22949例患者,包括合并心房颤动的二尖瓣反流组12246例,不合并心房颤动的二尖瓣反流组10703例。Meta分析结果显示,合并心房颤动的二尖瓣反流组行MitraClip术后全因死亡率较不合并心房颤动的二尖瓣反流组明显增高(OR=1.41,95%CI:1.28~1.55,P<0.05),两组在手术失败(OR=1.04,95%CI:0.86~1.24)、因心力衰竭再住院(OR=1.42,95%CI:0.99~2.05)及脑卒中(OR=1.05,95%CI:0.43~2.57)方面比较,差异均无统计学意义(P均>0.05)。结论 心房颤动是二尖瓣反流行MitraClip术后全因死亡的危险因素,但其他异位心律对于MitraClip介入治疗后的影响有待于进一步研究。Objective To evaluate the effect of atrial fibrillation(AF)on the outcomes of mitral regurgitation(MR)using Mitraclip.Methods Data-bases of PubMed,Cochrane Library,CNKI,Wanfang data and other databases were searched through computer,clinical studies that met the inclusion criteria were included.The statistical analysis was conducted by using Rev Man 5.4software.Results Eight clinical trials were finally enrolled with a total of 22949 patients,of whom 12246 were assigned to MR+AF group and 10703 to MR+non-AF group.Meta-analysis results showed that the all-cause mortality after MitraClip implanation in the MR+AF group was higher than that in the MR+non-AF group(OR=1.41,95%CI:1.28-1.55,P<0.05),the procedural failure(OR=1.04,95%CI:0.86-1.24),heart failure related hospitalization(OR=1.42,95%CI:0.99-2.05)and stroke(OR=1.05,95%CI:0.43-2.57)between two groups were not statistically significant(all P>0.05).Conclusion Atrial fibrillation is a risk factor for all-cause death after MitraClip implanation in patients with MR,but the effect of other ectopic rhythm on MitraClip interventional therapy needs further study.

关 键 词：二尖瓣反流 心房颤动 二尖瓣介入修复 MITRACLIP 

分 类 号：R499[医药卫生—康复医学]