冠状动脉内微导管给药治疗无复流现象疗效的Meta分析Treatment efficacy of intracoronary microcatheter agents in the patients with no-reflow phenomenon:a Meta analysis
曹野,邹远林,王伟琼,权欢欢,郭小梅
摘要(Abstract):
目的系统评价冠状动脉内微导管给药治疗无复流现象的疗效。方法计算机检索Pub Med、EMbase、the Cochrane Library、中国生物医学文献数据库、中国知网、维普网及万方数据库,搜集冠状动脉内给药治疗无复流现象的相关随机对照试验,检索时间限制为建库至2017年4月。由2位评价者独立筛选文献、提取资料和评价纳入文献的偏倚风险后,采用Rev Man5.3软件进行Meta分析。血栓抽吸导管、微导管或自制导管注射药物至靶血管给药为试验组,指引导管冠状动脉内给药为对照组。结果最终纳入8项随机对照试验,共424例患者。Meta分析结果显示,试验组的TIMI血流分级(RR0.38,95%CI 0.27~0.52,P<0.000 01)、TIMI心肌组织灌注分级(RR 0.35,95%CI 0.23~0.54,P<0.00001)、校正TIMI血流帧数(MD–9.99,95%CI–13.22~–6.76,P<0.000 01)及低血压发生率(RR 0.57,95%CI 0.35~0.90,P=0.02)均优于对照组;而短期主要不良心血管事件和左心室射血分数试验组与对照组比较,差异均无统计学意义(均P>0.05)。结论现有证据表明,经微导管给药在治疗冠状动脉无复流现象时可明显提高血流灌注水平,安全性好。受纳入研究质量和数量的限制,仍需大规模高质量随机对照试验予以验证。
关键词(KeyWords): 无复流现象;微导管;Meta分析
基金项目(Foundation): 国家自然科学基金(81270353)
作者(Author): 曹野,邹远林,王伟琼,权欢欢,郭小梅
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