钱翠平,彭稳中,张予,郭小梅

• 1:华中科技大学同济医学院附属同济医院心血管内科

摘要(Abstract)：

目的比较替罗非班经冠状动脉内注射与经静脉内注射在急性冠状动脉综合征(ACS)经皮冠状动脉介入治疗(PCI)中的疗效。方法计算机检索PubMed、EMBASE、中国生物医学文献数据库(CBM)、中国期刊全文数据库(CNKI)、中国科技期刊数据库(VIP)、Cochrane图书馆,全面收集在ACS患者的治疗中,替罗非班冠状动脉内及静脉内给药初始剂量的随机对照研究。对纳入的研究进行资料提取后采用Cochrane协作网提供的RevMan5.2统计软件进行Meta分析。结果共收集25篇符合纳入标准的随机对照研究,共计2516例患者。Meta分析结果显示,与替罗非班静脉内给药(IV组)相比,冠状动脉内给予(IC组)替罗非班更能显著增加PCI术后TIMIⅢ级血流比率(RR 1.15,95%CI 1.07~1.23,P=0.0001);PCI术后1周心脏超声评价两组左心室射血分数(LVEF)差异具有统计学意义,IC组LVEF较IV组平均增加2.69%(WMD 2.69,95%CI 0.14~5.25,P=0.04);冠状动脉内给予替罗非班更能有效降低PCI术后30 d随访主要不良心血管事件(MACE)的发生率(RR 0.51,95%CI 0.38~0.69,P<0.0001)。然而,PCI术后两组出血并发症发生率比较差异无统计学意义(RR 0.95,95%CI 0.76~1.19,P=0.64)。结论冠状动脉内给予替罗非班相比静脉内给予替罗非班更能有效增加冠状动脉血流和微血管灌注,能显著减少PCI术后随访30 d不良心血管事件的发生率,改善预后,且不增加出血风险。

关键词(KeyWords)： 急性冠状动脉综合征;经皮冠状动脉介入治疗;冠状动脉内;替罗非班

Abstract:

Keywords:

基金项目(Foundation): 国家自然科学基金(81270353)

作者(Author): 钱翠平,彭稳中,张予,郭小梅

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