ST 段抬高心肌梗死行介入治疗患者冠脉相对于静脉使用IIbIIIa 受体拮抗剂有效性及安全性的Meta 分析.docVIP

ST段抬高心肌梗死行介入治疗患者冠脉相对于静脉使用IIb/IIIa受体拮抗剂有效性及安全性的Meta分析 尹建，徐强，司良毅 （400038 重庆，第三军医大学附属西南医院老年病科) [摘要] 目的 系统评价ST段抬高心肌梗STEMI）行经皮冠状动脉介入PCI）患者，冠脉较静脉使用血小板糖蛋白IIb/IIIaGP IIb/IIIa)受体拮抗剂的有效性及安全性。 计算机检索美国国立生物医学信息中心PubMed数据库、Cochrane图书馆临床对照试验数据库、荷兰医学文摘embase数据库、中国生物医学文献数据库（CBM）中国期刊全文数据库（CJFD）同时检索相关网站，尽量获取会议摘要及灰色文献。使用RevMan5.1软件对纳入研究进行Meta分析。 共纳入11篇试验，总计1569例患者Meta分析结果示：冠脉较静脉使用GP IIb/IIIa受体拮抗剂能显著改善STEMI患者术后心肌梗死溶栓试验（TIMI）3级血流（RR=1.08，95%CI为1.04~1.13，P0.01）TIMI心肌组织灌注分级（TMPG）3级血流（RR=1.37，95%CI为1.16~1.63，P0.01）左室射血分数（MD=0.04，95%CI为0.02~0.06，P0.01）主要不良心脏事件（MACE）发生率（RR=0.4，95%CI为0.3~0.69，P0.01），同时不增加主要出血并发症（RR=1.04，95%CI为0.55~1.95，P=0.9）。阿昔单抗在此基础上能进一步降低1月时死亡率（RR=0.45，95%CI为0.21~0.99，P=0.05）。 冠脉较静脉途径使用GP IIb/IIIa受体拮抗剂能改善STEMI行PCI治疗患者术后罪犯血管再通、心肌灌注左心室功能恢复，降低主要不良心脏事件发生率，同时不增加主要出血并发症。 [] Meta分析；心肌梗死；替罗非班；阿昔单抗 [中图法分类号] R541.4；R972+.4；R452versus intravenous administration of glycoprotein IIb/IIIa inhibitors in primary percutaneous coronary intervention of ST-segment elevation myocardial infarction: a systematic review Yin Jian, Xu Qiang, Si Liangyi (Department of Geriatrics, Southwest Hospital of The Third Military Medical University, Chongqing, 400038, China) [Abstract] Objective To evaluate the efficiency and safety of intracoronary versus intravenous administration of glycoprotein IIb/IIIa (GP IIb/IIIa) inhibitors in patients with ST-segment elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI). Methods We searched for randomized controlled trials in the following databases: PubMed, Embase, The Cochrane library (Issue 2, 2011), CBM and CJFD. Besides, according to the Cochrane Handbook, we searched relative websites for unpublishment and grey literatures, and obtained the latest trials through the Google search. Quality assessment and data extraction were conducted by two reviewers independently. Disagreements were resolved through discussion. All data were analyzed by using Review Manager 5.1. Results Eleven trials were included in the meta-