CAJ | 학술논문

目的使用Meta分析比较常规体外循环冠状动脉旁路移植术(CCABG)和非体外循环冠状动脉旁路移植术(OPCAB)术后心肌梗死发生率的差异.方法在 Medline、SCI、Cochrane图书馆临床对照试验注册库(CENTRAL)和中国生物医学文献光盘数据库(CBMdisc)检索中文和英文的相天随机对照临床试验,并检索相关文献的参考文献,检索时间截止至2009年1月.根据严格的纳入和排除标准,两名评价员独立地筛选文献,并按照Cochrane系统评价员手册5.0.0版所建议的评价方法对纳入临床试验进行质量评价,最后将提取的资料用RevMan 5软件进行数据处理和分析.结果共纳入22个试验进行Meta分析,OPCAB组共纳入1494例病人,心肌梗死总发生率为2.81%;CCABG组共1512例,心肌梗死总发生率为3.57%.Meta分析结果显示OPCAB和CCABG术后心肌梗死发生率的差异尤统计学意义(OR=0.80,95%CI=0.54～1.20,P=0.28).结论依据现有的随机对照试验进行Meta分析结果显示,OPCAB和CCABG术后心肌梗死发生率的差异无统计学意义.
목적 사용Meta분석비교상규체외순배관상동맥방로이식술(CCABG)화비체외순배관상동맥방로이식술(OPCAB)술후심기경사발생솔적차이.방법 재 Medline、SCI、Cochrane도서관림상대조시험주책고(CENTRAL)화중국생물의학문헌광반수거고(CBMdisc)검색중문화영문적상천수궤대조림상시험,병검색상관문헌적삼고문헌,검색시간절지지2009년1월.근거엄격적납입화배제표준,량명평개원독입지사선문헌,병안조Cochrane계통평개원수책5.0.0판소건의적평개방법 대납입림상시험진행질량평개,최후장제취적자료용RevMan 5연건진행수거처리화분석.결과 공납입22개시험진행Meta분석,OPCAB조공납입1494례병인,심기경사총발생솔위2.81%;CCABG조공1512례,심기경사총발생솔위3.57%.Meta분석결과 현시OPCAB화CCABG술후심기경사발생솔적차이우통계학의의(OR=0.80,95%CI=0.54～1.20,P=0.28).결론 의거현유적수궤대조시험진행Meta분석결과 현시,OPCAB화CCABG술후심기경사발생솔적차이무통계학의의.
Objective The efficacy and safety of off-pump coronary artery bypass grafting (OPCAB) as comparing with conventional coronary artery bypass grafting(CCABG) remain inconclusive in randomized, controlled trials and retrospective studies. We tried to assess the incidence of myocardial infarction (MI) after OPCAB and CCABG. with a meta analysis based on published data in randomized ,controlled trials. Methods Relevant randomized controlled trials, published in English and Chinese before January 2009, were searched in Medline, the Science Citation Index Expanded, the Cochrane Central Register of Controlled Trials (CENTRAL) and CBMdisc. Manual searching of bibliographies were performed, with key words "oronary artery bypass graft", "off-pump" and "myocardial infarction". Two reviewers selected eligible trials independently, performed quality assessment and collected relevant data. Meta-analysis was performed with software RevMan 5. Results 22 trials were considered to be eligible for the meta analysis. The incidence of MI was 2.81% (42/1494) in the OPCAB group as compared with 3.57% (54/1512) in the CCABG group. No significant difference was present between the two groups (OR =0.80,95% CI =0.54 - 1.20, P =0.28). Conclusion Our meta analysis of current available randomized controlled trials involving OPCAB and CCABG in patients with coronary artery diseases suggests that the difference in the incidence of postoperative MI between CCABG and OPCAB groups is not significant.