CAJ | 학술논문

目的：使用Meta分析的方法评价颈动脉内膜切除术(CEA)与脑保护装置(EPD)下颈动脉血管成形术(CAS)治疗颈动脉狭窄的近期疗效和安全性。方法计算机检索2000年1月-2013年12月PubMed、MEDLINE、EMbase、cochrane图书馆、中国期刊全文数据库(CNKI)、万方医学数据库以及中文科技期刊数据库(VIP)，收集CEA和CAS+EPD治疗颈动脉狭窄的随机对照试验，采用RevMan 5.0软件进行Meta分析。结果共纳入6个符合要求的研究，3771例患者，其中CEA组1874例， CAS组1897例。CAS+EPD组术后30 d脑卒中风险（RR=1.78,95%CI：1.25~2.52，P=0.001）以及脑卒中或死亡联合发生风险（RR=1.62，95%CI：1.19~2.21，P=0.002）均高于CEA组。结论颈动脉血管成形术组治疗颈动脉狭窄的近期疗效与安全性方面未显示优于内膜切除术组。
목적：사용Meta분석적방법평개경동맥내막절제술(CEA)여뇌보호장치(EPD)하경동맥혈관성형술(CAS)치료경동맥협착적근기료효화안전성。방법계산궤검색2000년1월-2013년12월PubMed、MEDLINE、EMbase、cochrane도서관、중국기간전문수거고(CNKI)、만방의학수거고이급중문과기기간수거고(VIP)，수집CEA화CAS+EPD치료경동맥협착적수궤대조시험，채용RevMan 5.0연건진행Meta분석。결과공납입6개부합요구적연구，3771례환자，기중CEA조1874례， CAS조1897례。CAS+EPD조술후30 d뇌졸중풍험（RR=1.78,95%CI：1.25~2.52，P=0.001）이급뇌졸중혹사망연합발생풍험（RR=1.62，95%CI：1.19~2.21，P=0.002）균고우CEA조。결론경동맥혈관성형술조치료경동맥협착적근기료효여안전성방면미현시우우내막절제술조。
Objective To evaluate the short-term clinical efficacy and safety of carotid endarterectomy(CEA) versus carotid angio-plasty and stenting (CAS) with embolic protection device (EPD) for the treatment of carotid stenosis by meta-analysis method. Methods We searched the electronic databases (PubMed, MEDLINE, EMbase, Cochrane Central Register of Controlled Trials, CNKI, Wanfang and VIP) in order to retrieve randomized controlled trials (RCTs) about comparing CEA and CAS with EPD for the treatment of carotid stenosis. Cochrane collaboration's RevMan 5.0 was used for meta-analysis. Results A total of six RCTs, total-ing 3771 patients (1874 patients were randomized to CEA group, 1897 patients were randomized to CAS group) were included in the meta-analysis. There were significantly higher 30-day relative risks after CAS with EPD than after CEA for stroke (RR=1.78, 95%CI:1.25~2.52, P=0.001)and for death or stroke (RR=1.62, 95%CI:1.19~2.21, P=0.002). Conclusion The available clinical data indicate that the short-term efficacy and safety of CAS with EPD in the treatment of carotid stenosis are not superior to CEA.