中华心血管病杂志
中華心血管病雜誌
중화심혈관병잡지
Chinese Journal of Cardiology
2013年
5期
432-437
,共6页
张贤锐%苏立%陈少杰%张晓歌%殷跃辉
張賢銳%囌立%陳少傑%張曉歌%慇躍輝
장현예%소립%진소걸%장효가%은약휘
心肌梗死%主动脉内气囊泵%死亡率%治疗结果
心肌梗死%主動脈內氣囊泵%死亡率%治療結果
심기경사%주동맥내기낭빙%사망솔%치료결과
Myocardial infarction%Intra-aortic balloon pumping%Mortality%Treatment outcome
目的 应用荟萃分析的方法探讨临床上使用主动脉球囊反搏(IABP)辅助治疗急性心肌梗死(AMI)的有效性及安全性.方法 通过Pubmed、EMBase、Cochrane、中国生物医学文献、万方、维普、中国知网等数据库,检索以使用主动脉球囊反搏辅助治疗急性心肌梗死为主要研究内容的临床随机对照研究(RCT),应用RevMan 5.1软件进行统计分析.结果 检索筛选到1980-2012年共13个随机对照试验,1958例AMI纳入分析研究,其中接受IABP治疗组970例,未经IABP治疗组(对照组)988例.IABP治疗组30 d内的病死率与对照组比较差异无统计学意义(RR =0.77,95％ CI 0.58～ 1.03,P =0.08)；但在伴有心原性休克亚组中,IABP治疗组30 d病死率低于对照组(RR=0.65,95％CI0.44 ～0.97,P =0.04).IABP治疗组6个月后的病死率明显低于对照组(RR =0.72,95％ CI0.55 ～0.94,P=0.02),且亚组分析与总体分析结果相似.IABP组的治疗相关出血事件高于对照组(RR=1.43,95％CI 1.16 ～ 1.75,P ＜0.01).结论 IABP治疗可降低AMI l ～6个月的病死率,对伴心原性休克的AMI患者更能早期获益.
目的 應用薈萃分析的方法探討臨床上使用主動脈毬囊反搏(IABP)輔助治療急性心肌梗死(AMI)的有效性及安全性.方法 通過Pubmed、EMBase、Cochrane、中國生物醫學文獻、萬方、維普、中國知網等數據庫,檢索以使用主動脈毬囊反搏輔助治療急性心肌梗死為主要研究內容的臨床隨機對照研究(RCT),應用RevMan 5.1軟件進行統計分析.結果 檢索篩選到1980-2012年共13箇隨機對照試驗,1958例AMI納入分析研究,其中接受IABP治療組970例,未經IABP治療組(對照組)988例.IABP治療組30 d內的病死率與對照組比較差異無統計學意義(RR =0.77,95％ CI 0.58～ 1.03,P =0.08)；但在伴有心原性休剋亞組中,IABP治療組30 d病死率低于對照組(RR=0.65,95％CI0.44 ～0.97,P =0.04).IABP治療組6箇月後的病死率明顯低于對照組(RR =0.72,95％ CI0.55 ～0.94,P=0.02),且亞組分析與總體分析結果相似.IABP組的治療相關齣血事件高于對照組(RR=1.43,95％CI 1.16 ～ 1.75,P ＜0.01).結論 IABP治療可降低AMI l ～6箇月的病死率,對伴心原性休剋的AMI患者更能早期穫益.
목적 응용회췌분석적방법탐토림상상사용주동맥구낭반박(IABP)보조치료급성심기경사(AMI)적유효성급안전성.방법 통과Pubmed、EMBase、Cochrane、중국생물의학문헌、만방、유보、중국지망등수거고,검색이사용주동맥구낭반박보조치료급성심기경사위주요연구내용적림상수궤대조연구(RCT),응용RevMan 5.1연건진행통계분석.결과 검색사선도1980-2012년공13개수궤대조시험,1958례AMI납입분석연구,기중접수IABP치료조970례,미경IABP치료조(대조조)988례.IABP치료조30 d내적병사솔여대조조비교차이무통계학의의(RR =0.77,95％ CI 0.58～ 1.03,P =0.08)；단재반유심원성휴극아조중,IABP치료조30 d병사솔저우대조조(RR=0.65,95％CI0.44 ～0.97,P =0.04).IABP치료조6개월후적병사솔명현저우대조조(RR =0.72,95％ CI0.55 ～0.94,P=0.02),차아조분석여총체분석결과상사.IABP조적치료상관출혈사건고우대조조(RR=1.43,95％CI 1.16 ～ 1.75,P ＜0.01).결론 IABP치료가강저AMI l ～6개월적병사솔,대반심원성휴극적AMI환자경능조기획익.
Objective To analyze the efficacy and safety of intra-aortic balloon pump (IABP) therapy in patients with acute myocardial infarction (AMI) based on the meta-analysis.Methods Eligible published randomized controlled clinical research (RCT) were retrieved in the Pubmed,EMBase,Cochrane,China biological medical literature,Wanfang,VIP and CNKI database from 1980 to April 2,2012.The analysis was performed with the software of RevMan 5.1.Results Thirteen RCTs with 1958 patients (AMI with IABP therapy,n =970,without IABP therapy,n =988) were included.The 30-day mortality between the two groups was similar (RR =0.77,95％ CI 0.58-1.03,P =0.08),but the 30-day mortality in the cardiac shock subgroup was significantly lower in IABP group than in without IABP group (RR =0.65,95 ％ CI 0.44-0.97,P =0.04).The 6-month mortality was significantly lower in IABP group than in without IABP group (RR =0.72,95 ％ CI 0.55-0.94,P =0.02).The incidence of major bleeding was significantly higher in IABP group than in withoutIABP group (RR =1.43,95％ CI 1.16-1.75,P ＜0.01).Conclusion IABP therapy is effective to reduce earlier mortality post AMI,particularly for patients with cardiac shock.
