急性心肌梗死后早期氧疗疗效的Meta分析

发布时间：2018-03-27 08:09

  本文选题：急性心肌梗死　切入点：氧疗　出处：《重庆医科大学》2017年硕士论文

【摘要】：目的系统评价急性心肌梗死后早期氧疗的疗效。方法计算机检索PubMed、EMbase、The Cochrane Library(2015年第11期)和CBM数据库,搜集急性心肌梗死后早期氧疗的相关随机对照试验(RCT),检索时限均从建库至2015年11月。由2名评价者独立筛选文献、提取资料并评价纳入研究的偏倚风险评价后,采用Rev Man 5.3软件进行Meta分析。结果共纳入7个RCT,共1388例患者。Meta分析结果显示:氧疗组和空气组患者的病死率[OR=1.12,95%CI(0.57,2.20),P=0.75]、主要心血管事件发生率(MACCE)[OR=1.00,95%CI(0.46,2.18),P=1.00]、住院期间发生心律失常发生率[OR=1.01,95%CI(0.45,2.24),P=0.98]和心源性死亡发生率[OR=0.53,95%CI(0.17,1.69),P=0.28]的差异均无统计学意义。但氧疗组的再发心肌梗死发生率明显高于对照组[OR=5.73,95%CI(1.47,22.31),P=0.01],平均住院时间明显长于对照组[MD=1.28,95%CI(1.10,1.47),P0.00001],且差异具有统计学意义。结论氧疗用于治疗急性心肌梗死疗效不明确且有增加再发心肌梗死、延长平均住院时间的可能。受纳入研究数量和质量限制,上述结论尚需开展更多高质量研究予以验证。
[Abstract]:Objective to evaluate the efficacy of early oxygen therapy after acute myocardial infarction (AMI). Methods the Cochrane Library (issue 11 of 2015) and CBM database were searched by computer. A randomized controlled trial of early oxygen therapy after acute myocardial infarction (AMI) was collected. The retrieval time was from the establishment of the database to November 2015. Two evaluators independently screened the literature, extracted the data and evaluated the bias risk assessment that was included in the study. Rev Man 5.3 software was used to carry out Meta analysis. Results the results of Meta analysis included 7 RCTs and 1388 patients. The results showed that the mortality rate of patients in oxygen therapy group and air group [OR1.1295CI0.572.20], the incidence of major cardiovascular events was MacCE0.75] [OR1.0095CI0.46V2.18P0. 00], arrhythmias occurred during hospitalization. The incidence of recurrent myocardial infarction in the oxygen therapy group was significantly higher than that in the control group [OR5.795 CI1.4777.22.31] and the average hospitalization time was significantly longer than that in the control group [MD1.28995 CI 1.101.47P0.00001], but the incidence of recurrent myocardial infarction in the oxygen therapy group was significantly higher than that in the control group (OR5.795CI1.477.22.31P0. 01), and the incidence of cardiogenic death was not significantly different from that of the control group [OR0.5395 CII 0.171.69], and the difference was statistically significant in the oxygen therapy group (Or5.795 CI1.4795 CI1.477.22.31P0. 01), and the average hospital stay was significantly longer than that in the control group (MD1.2895CII 1.101.47P0.00001). Conclusion oxygen therapy is not effective in the treatment of acute myocardial infarction and can increase the recurrence of myocardial infarction. The possibility of prolonging the average length of stay is limited by the quantity and quality of the studies included, and these conclusions need to be verified by more high-quality studies.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R542.22

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