心脏震荡波对冠状动脉疾病影响的Meta分析  

Efficacy of cardiac shock wave therapy on coronary artery disease:a meta-analysis

作　　者：张艺凡 刘姝彤 张宁[1] 刘璐瑶 焦雪妍 兰真真 陈云[3] 刘新灿[3] ZHANG Yifan;LIU Shutong;ZHANG Ning;LIU Luyao;JIAO Xueyan;LAN Zhenzhen;CHEN Yun;LIU Xincan(Henan University of Traditional Chinese Medicine,Zhengzhou 450000,P.R.China;Zhengzhou University,Zhengzhou 450000,P.R.China;The First Affiliated Hospital of Henan University of Traditional Chinese Medicine,Zhengzhou 450000,P.R.China)

机构地区：[1]河南中医药大学,郑州450000 [2]郑州大学,郑州450000 [3]河南中医药大学第一附属医院,郑州450000

出　　处：《中国循证医学杂志》2023年第5期539-543,共5页Chinese Journal of Evidence-based Medicine

基　　金：河南省中医药科学研究专项课题(编号:2022ZY1044)。

摘　　要：目的系统评价心脏震荡波对冠状动脉疾病的影响。方法计算机检索PubMed、Cochrane Library、Wed of Science、EMbase、Clinical Trails.gov、CNKI、WanFang Data、VIP和CBM数据库,搜集有关心脏震荡波治疗冠状动脉疾病的随机对照试验和队列研究,检索时限均从建库至2022年8月。由2位评价员独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用RevMan 5.4.1和Stata 15.0软件进行Meta分析。结果共纳入11个研究,包括519例患者。Meta分析结果显示:与对照组相比,心脏震荡波治疗能降低再住院率[RR=0.38,95%CI(0.25,0.57),P<0.01],提高运动时间[SMD=0.93,95%CI(0.17,1.70),P=0.02],改善加拿大心血管学会(CCS)心绞痛分级[MD=-0.62,95%CI(-0.73,-0.51),P<0.01]、纽约心脏协会(NYHA)心功能分级[MD=-0.60,95%CI(-0.85,-0.35),P<0.01]、左室射血分数[MD=4.81,95%CI(3.17,6.46),P<0.01]、西雅图心绞痛量表(SAQ)总评分[MD=10.87,95%CI(4.63,17.12),P<0.01]和6分钟步行试验能力[MD=85.06,95%CI(31.02,139.09),P<0.01]。结论心脏震波治疗不仅能改善冠状动脉疾病患者心功能,还可以改善预后和运动能力。受纳入研究数量和质量限制,上述结论尚需开展更多高质量研究予以验证。Objective To systematically review the impact of cardiac shock waves on coronary artery disease.Methods The PubMed,Cochrane Library,Wed of Science,EMbase,ClinicalTrials.gov,CNKI,WanFang Data,VIP and CBM databases were electronically searched to collect randomized controlled trials and cohort studies related to the treatment of coronary artery disease with cardiac shock waves from inception to August 2022.After two evaluators independently screened the literature,extracted data,and evaluated the risk of bias of the included studies,a meta-analysis was conducted by using RevMan 5.4.1 and Stata 15.0 software.Results A total of 11 studies with 519 patients were included.The meta-analysis results revealed that compared with the control group,cardiac shock wave therapy could reduce hospitalization rates(RR=0.38,95%CI 0.25 to 0.57,P<0.01),increase exercise time(SMD=0.93,95%CI 0.17 to 1.70,P=0.02),and improve the Canadian Cardiovascular Society(CCS)angina grading(MD=−0.62,95%CI−0.73 to−0.51,P<0.01),the New York Heart Association(NYHA)cardiac function grading(MD=−0.60,95%CI−0.85 to−0.35,P<0.01),left ventricular ejection fraction(MD=4.81,95%CI 3.17 to 6.46,P<0.01),total score of the Seattle angina questionnaire(SAQ)(MD=10.87,95%CI 4.63 to 17.12,P<0.01),and 6-min walking test(MD=85.06,95%CI 31.02 to 139.09,P<0.01).Conclusion Cardiac shock wave therapy can improve cardiac function as well as the prognosis and exercise ability.Due to the limited quantity and quality of the included studies,more high-quality studies are needed to verify the above conclusion.

关 键 词：心脏震荡波 冠状动脉疾病 系统评价 META分析 

分 类 号：R541.4[医药卫生—心血管疾病]