摘要
目的:系统评价血管内超声(intravascular ultrasound,IVUS)与冠状动脉造影指导的经皮冠状动脉介入(percutaneous coronary intervention,PCI)治疗急性心肌梗死的疗效和安全性。方法:计算机检索PubMed、EMBASE、Web of Science、Cochrane图书馆、CBM、CNKI、维普数据库和万方数据库,纳入血管内超声在急性心肌梗死PCI治疗中应用的相关临床研究,采用RevMan5.3统计软件进行Meta分析。结果:最终纳入9篇满足要求的临床研究,共计39 302例患者。Meta分析结果显示:与冠状动脉造影指导的急性心肌梗死PCI治疗相比,IVUS指导PCI的主要心血管不良事件(OR=0.80,95%CI:0.74~0.86,P <0.00001)、心源性死亡(OR=0.64,95%CI:0.48~0.85,P=0.002)、心肌梗死(OR=0.86,95%CI:0.74~0.99,P=0.04)、支架内血栓(OR=0.65,95%CI:0.49~0.88,P=0.005)、靶血管血运重建(OR=0.80,95%CI:0.68~0.93,P=0.005)、全因死亡(OR=0.68,95%CI:0.58~0.80,P <0.00001)的发生率均降低;两组靶病变血运重建(OR=0.90,95%CI:0.77~1.06,P=0.22)发生率的差异无统计学意义。结论:IVUS指导急性心肌梗死的PCI治疗是安全有效的,可进一步优化急性心肌梗死患者的PCI治疗,达到改善患者预后作用。
Objective:To evaluate the efficacy and safety of percutaneous coronary intervention(PCI)guided by intravascular ultrasound(IVUS)vs coronary angiography in the treatment of acute myocardial infarction.Methods:The databases searched included PubMed,Embase,Web of Science,Cochrane Library,CBM,CNKI,VIP,Wanfang Database,meta-analysis was conducted by using RevMan 5.3 software.Results:There were 9 included clinical studies with 39302 cases.The result of Meta analysis showed that,compared with the coronary angiography group,the incidence about major cardiovascular events(OR=0.80,�95%CI:0.74-0.86,�P<0.00001),Cardiac death(OR=0.64,95%CI:0.48-0.85,P=0.002),Myocardial infarction(OR=0.86,95%CI:0.74-0.99,P=0.04),Stent thrombosis(OR=0.65,95%CI:0.49-0.88,P=0.005),Target vessel revascularization(OR=0.80,95%CI:0.68-0.93,P=0.005),and all-cause mortality(OR=0.68,95%CI:0.58-0.80,P<0.00001)in the IVUS group were lower.The Target lesion revascularization between two groups had no statistical difference(OR=0.90,95%CI:0.77-1.06,P=0.22).Conclusions:Ivus-guided PCI in acute myocardial infarction is safe and effective,and can further optimize interventional therapy for acute myocardial infarction to improve the prognosis of patients.
作者
严广东
李彪
陈希伟
杨惠
杨靖涌
张少衡
YAN Guangdong;LI Biao;CHEN Xiwei;YANG Hui;YANG Jingyong;ZHANG Shaoheng(Department of Cardiovascular Medicine,Guangzhou Red Cross Hospital of Jinan University,Guangzhou 510235,China)
出处
《心肺血管病杂志》
CAS
2023年第8期850-858,共9页
Journal of Cardiovascular and Pulmonary Diseases
基金
广州市科技计划项目(907297347045)。
关键词
血管内超声
冠状动脉造影
急性心肌梗死
冠状动脉介入治疗
META分析
系统评价
Intravascular ultrasound
Coronary angiography
Acute myocardial infarction
Percutaneous coronary intervention
Meta analysis
Systematic review
