国产重组人尿激酶原治疗急性心肌梗死有效性和安全性的Meta分析

发布时间：2018-05-11 17:52

本文选题：心肌梗死 + 尿激酶型纤溶酶原激活物　；参考：《中国全科医学》2016年17期

【摘要】：目的探讨国产重组人尿激酶原治疗急性心肌梗死(AMI)的有效性和安全性。方法计算机检索Pub Med、EMBase、Cochrane Library、中国知网、维普网、万方数据知识服务平台等数据库中已发表的观察国产重组人尿激酶原治疗AMI安全性和有效性的文献,时间限定为建库至2015年9月。由两名评价员独立进行文献筛选和质量评价,按预先设计的表格提取资料,包括第一作者、发表时间、治疗时间、年龄、样本量、剂量及评价指标。纳入文献首先进行异质性分析,分类变量采用比值比(OR值)及其95%CI为合并效应量。结果共纳入10篇文献,AMI患者875例,方法学质量评价均为B级。国产重组人尿激酶原治疗AMI患者再通率〔OR=2.63,95%CI(1.95,3.54)〕、完全再通率〔OR=2.85,95%CI(2.09,3.89)〕高于尿激酶,30 d主要不良心血管事件(MACE)发生率〔OR=0.42,95%CI(0.27,0.65)〕、轻微出血发生率〔OR=0.52,95%CI(0.33,0.81)〕、出血发生率〔OR=0.41,95%CI(0.28,0.62)〕低于尿激酶,差异有统计学意义(P0.05)。国产重组人尿激酶原与尿激酶治疗AMI患者严重出血发生率比较,差异无统计学意义〔OR=0.24,95%CI(0.05,1.12),P=0.07〕。结论与尿激酶相比,国产重组人尿激酶原治疗AMI患者血管再通率高,MACE发生率低,出血并发症少。
[Abstract]:Objective to evaluate the efficacy and safety of domestic recombinant human urokinase in the treatment of acute myocardial infarction (AMI). Methods A computer search was carried out to search the published literatures on the safety and efficacy of domestic recombinant human urokinase in the database of Pub Medsite, China knowledge Network, Wiplnet and Wanfang data knowledge Service platform for the treatment of AMI. The time limit was to build the database until September 2015. Literature screening and quality evaluation were carried out independently by two evaluators, and the data were extracted according to pre-designed tables, including the first author, time of publication, time of treatment, age, sample size, dose and evaluation index. In the literature, the heterogeneity was analyzed first, and the ratio or (OR) and its 95%CI were used as the combined effect. Results A total of 875 patients with AMI were included in 10 articles. The rate of recanalization of patients with AMI treated by domestic recombinant human urokinase was 1.955 / 3.54 and the rate of complete recanalization was 2.859 / 95 respectively), which was higher than that of urokinase / urokinase for 30 days, the incidence of major adverse cardiovascular events was higher than that of OR0.4295CI0.270.650.The incidence of slight hemorrhage was 0.330.81. The incidence of hemorrhage was lower than that of urokinase (P 0.05). There was no significant difference in the incidence of severe hemorrhage between domestic recombinant human urokinase and urokinase in AMI patients. Conclusion compared with urokinase, the rate of vascular recanalization in patients with AMI treated by domestic recombinant human urokinase is higher than that of urokinase, and the incidence of Mace is lower and the complication of bleeding is less.
【作者单位】：河北医科大学第二医院心血管内科;
【分类号】：R542.22

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