感染性心内膜炎患者赘生物大小与栓塞事件及全因死亡率相关性的荟萃分析  

The relationship between vegetation size and embolic events, all-cause mortality in infective endocarditis patients: a meta-analysis

作　　者：吴永超 韦帮缓 陈光献[1] 吴钟凯[1] 许哲[1] WU Yongchao;WEI Banghuan;CHEN Guangxian;WU Zhongkai;XU Zhe(Department of Cardiac Surgery,The First Affiliated Hospital of Sun-Yat-Sen University,Guangzhou,510080,China;Department of Cardiac Surgery,The First Dongguan Affiliated Hospital of Guangdong Medical University)

机构地区：[1]中山大学附属第一医院心外科,广州510080 [2]广东医科大学附属东莞第一医院心外科

出　　处：《临床心血管病杂志》2024年第7期553-559,共7页Journal of Clinical Cardiology

基　　金：国家自然科学基金(No:82070297);国家重点研发计划(No:2023YFC2706200);广州市科技计划(No:202103000014)。

摘　　要：目的:评价赘生物大小与感染性心内膜炎患者栓塞事件和全因死亡率的相关性。方法:检索EMBASE、Pubmed、Elservise及Cochrane数据库截至2024年3月提供赘生物≥10 mm与<10 mm两组患者栓塞事件和(或)全因死亡率数据的研究,然后按照Newcastle-Ottawa量表进行严格的文献评价后进行meta分析。结果:纳入24项研究,共8 873例感染性心内膜炎患者,其中7 191例有赘生物大小的资料。荟萃分析结果显示,与赘生物<10 mm相比,赘生物≥10 mm明显增加了感染性心内膜炎患者的栓塞事件发生率(OR=2.05,95%CI:1.63~2.56,P<0.001)和全因死亡率(OR=1.51,95%CI:1.28~1.78,P<0.001),这种相关性随着时间的积累越来越明显。结论:赘生物≥10 mm明显增加感染性心内膜炎患者的栓塞事件发生率和全因死亡率。Objective To evaluate the correlation between vegetation size and embolism and all-cause mortality in patients with infective endocarditis by meta-analysis.Methods Relevant trials reported before March 2024 were identified in EMBASE, Pubmed, Elservise and Cochrane. The outcomes included the association of a vegetation size ≥10 mm and<10 mm with embolic events and all-cause mortality in patients with infective endocarditis. A meta-analysis was conducted after a rigorous literature evaluation using the Newcastle Ottawa scale.Results Twenty-four studies with a total of 8 873 patients with infective endocarditis were included, of which 7 191 had data on the size of vegetations. The meta-analysis results showed that compared to vegetations<10 mm, vegetations ≥10 mm significantly increased the incidence of embolic events(OR=2.05, 95%CI: 1.63-2.56, P<0.001) and all-cause mortality(OR=1.51, 95%CI: 1.28-1.78, P<0.001) in patients with infective endocarditis. This correlation became increasingly evident over time.Conclusion Vegetation ≥10 mm significantly increases the incidence of embolic events and all-cause mortality in patients with infective endocarditis.

关 键 词：感染性心内膜炎 赘生物 栓塞事件 全因死亡率 荟萃分析 

分 类 号：R542.2[医药卫生—心血管疾病]