神经药理学报 ›› 2023, Vol. 13 ›› Issue (6): 21-.DOI: 10.3969/j.issn.2095-1396.2023.06.005

• 研究论文 • 上一篇    下一篇

替罗非班联合血栓抽吸在经皮冠脉介入术中疗效与安全性的Meta分析

杨博,赵晓敏,鲁濛,张泽鹏,武昌莎,李方江   

  1. 1. 河北北方学院研究生学院,张家口,075000,中国 

    2. 河北北方学院附属第一医院心血管内科,张家口,075000,中国

  • 出版日期:2023-12-26 发布日期:2024-05-08
  • 通讯作者: 李方江, 主任医师;研究方向:心血管内科;E-mail:lfj6789@163.com
  • 作者简介:杨博, 在读研究生;研究方向:心血管内科;E-mail:312478162@qq.com

Efficacy and Safety of Tirofiban Combined with Thromboaspiration in Percutaneous Coronary Intervention Surgery: A Meta-Analysis

YANG Bo, ZHAO Xiao-min, LU Meng, ZHANG Ze-peng, WU Chang-sha, LI Fang-jiang   

  1. 1. Graduate School of Hebei North University, Zhangjiakou, 075000, China 

    2. Department of Cardiology, the First Affiliated Hospital of Hebei North University, Zhangjiakou, 075000, China

  • Online:2023-12-26 Published:2024-05-08
  • Contact: 李方江, 主任医师;研究方向:心血管内科;E-mail:lfj6789@163.com
  • About author:杨博, 在读研究生;研究方向:心血管内科;E-mail:312478162@qq.com

摘要:

目的:分析经皮冠脉介入(percutaneous coronary intervention, PCI)术中血栓抽吸联合冠状动脉内注 射替罗非班的疗效及安全性。方法:计算机检索PubMed、Embase、Cochrane Library、中国知网、万方数据库、 维普数据库、中国生物医学文献数据库从建库至2022 年11 月公开发表的文献。由两名研究者进行质量评价, 运用Revman 5.3 软件进行统计学分析。结果:共纳入7 篇随机对照临床试验,共1 152 名患者,其中联合治疗 组585 例,单纯PCI 组567 例。其中男性708 例,女性444 例。依据Meta 分析结果提示,联合组治疗急性心梗 (acute myocardial infarction, AMI)患者后ST 段回落大于50% 例数(RR=1.23, 95%CI 1.14~1.33,P<0.01);术后 TIMI3 级血流(RR=1.20, 95%CI 1.14~1.27,P<0.01);左心室射血分数(left ventricular ejection fraction, LVEF) (MD=3.32, 95%CI 1.51~5.13,P<0.01);左心室舒张末期内径(left ventricular end diastolic diameter, LVEDD) (MD=-2.22, 95%CI -4.17~ -0.28,P<0.05);肌酸激酶同工酶(creatine kinase isoenzyme, CKMB)峰值(MD=- 111.85, 95%CI -116.43~ -107.27,P<0.01)均优于单纯PCI 组,联合治疗组主要心血管不良事件(major adverse cardiovascular events, MACE)发生率(RR=0.54, 95%CI 0.38~0.75,P<0.01)低于单纯PCI 组。结论:联合治疗 组的疗效及安全性均优于单纯PCI 组。

关键词: 血栓抽吸, 替罗非班, 心肌梗死, Meta 分析

Abstract:

Objective:To analyze the efficacy and safety of thrombus aspiration combined with intracoronary injection of tirofiban during percutaneous coronary intervention (PCI). Methods: PubMed, Embase, Cochrane Library, CNKI, Wanfang Database, Weipu Database (VIP), and China Biomedical Literature Database were searched in computer from the establishment of the library to the publication of the literature in November 2022. Quality was assessed by two investigators and statistically analyzed using Revman 5.3 software. Results: A total of 7 randomized controlled trials with a total of 1 152 patients were included, including 585 in the combination therapy group and 567 in the PCI alone group. Among them, 708 were males and 444 were females. According to the results of meta-analysis, the ST segment drop in patients treated with acute myocardial infarction (AMI) in the combination group was greater than 50% (RR=1.23, 95%CI 1.14~1.33, P<0.01), postoperative TIMI grade 3 blood flow (RR=1.20, 95%CI 1.14~1.27,P<0.01), left ventricular ejection fraction( LVEF)( MD=3.32, 95%CI 1.51~5.13,P<0.01), left ventricular end diastolic diameter( LVEDD)( MD=-2.22, 95%CI -4.17~-0.28,P<0.05), creatine kinase isoenzyme( CKMB) peak (MD=-111.85, 95%CI -116.43~-107.27, P<0.01) were better than PCI alone, and the incidence of major adverse cardiovascular events (MACE) in the combination therapy group (RR=0.54, 95%CI 0.38~0.75, P<0.01) was lower than PCI alone. Conclusion: The efficacy and safety of the combination therapy group were better than those in the PCI alone group.

Key words: thrombectomy, tirofiban, myocardial infarction, meta-analysis