负荷他汀类药物对急性ST段抬高型心肌梗死患者介入治疗术后疗效的Meta分析

发布时间：2018-05-17 05:20

本文选题：阿托伐他汀 + 瑞舒伐他汀　；参考：《第三军医大学学报》2017年23期

【摘要】：目的评价负荷他汀类药物对急性ST段抬高型心肌梗死(ST-segment elevation myocardial infarction,STEMI)患者经皮冠状动脉介入(percutaneous coronary intervention,PCI)治疗术后的疗效。方法计算机检索Pub Med、EMBASE、Cochrane Library等数据库,收集数据库建库至2017年3月的随机对照试验研究。两位评价者独立评价纳入研究质量、提取资料并交叉核对。采用Rev Man 5.3软件进行Meta分析。结果共纳入11项RCT研究,合计1 419例患者。PCI术前负荷他汀类药物对心肌梗死溶栓治疗(thrombolysis in myocardial infarction,TIMI)后血流的改善显著高于对照组(RR=1.09,95%CI:1.05~1.13,P0.01)。负荷组30 d主要心血管不良事件(major adverse cardiovascular events,MACEs)的发生率低于对照组(RR=0.50,95%CI:0.32~0.79,P0.01)。亚组分析结果显示:PCI术前单次负荷他汀治疗后30 d MACEs的发生率(RR=0.47,95%CI:0.22~1.01,P=0.05)。短期负荷他汀治疗后30 d MACEs的发生率(RR=0.52,95%CI:0.30~0.91,P0.05)。结论 STEMI患者负荷他汀治疗能改善PCI术后心肌血流灌注,能降低30 d MACEs的发生率。
[Abstract]:Objective to evaluate the effect of statin on percutaneous coronary intervention (percutaneous coronary interventionation) in patients with ST-segment elevation myocardial inflexion (ST-segment elevation myocardial infraction) after percutaneous coronary intervention (PCI). Methods Pub Medus EMBASE Cochrane Library and other databases were searched by computer, and the database was built up to March 2017 in a randomized controlled trial. The two reviewers independently evaluated the quality of the study, extracting data and cross-checking. Meta analysis was carried out with Rev Man 5.3 software. Results A total of 1 419 patients were enrolled in 11 RCT studies. The improvement of blood flow after thrombolytic therapy with thrombolytic therapy was significantly higher than that in control group (P 0.01). The incidence of major adverse cardiovascular events in the load group was lower than that in the control group. The results of subgroup analysis showed that the incidence of MACEs 30 days after single load statin therapy was 0.57% and 0.221.01% respectively. The incidence of MACEs at 30 days after short-term load statin therapy was 0. 52% CI: 0. 30% 0. 01% P 0. 05%. Conclusion loading statins in STEMI patients can improve myocardial perfusion after PCI and reduce the incidence of 30 d MACEs.
【作者单位】：重庆医科大学附属第二医院心血管内科;
【分类号】：R542.22

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