卵圆孔封堵术对比药物治疗预防隐源性脑梗死复发疗效的系统评价

发布时间：2018-06-05 07:18

本文选题：卵圆孔未闭 + 隐源性脑梗死　；参考：《广西医科大学》2014年硕士论文

【摘要】：目的：对药物治疗和卵圆孔封堵术预防隐源性脑梗死复发的安全性和有效性进行评价。方法：检索考克兰临床试验注册中心、Embase、Pubmed、美国临床试验注册中心、中国知网、万方数据库、维普中文期刊数据库、中国生物医学文献数据库。纳入研究设计均为随机对照试验，比较卵圆孔封堵术与药物治疗预防隐源性脑梗死复发率的差异，使用Review Manager5.2软件对所提取的数据进行统计分析，采用风险比、95%可信区间、p值描述结果，卡方检验与I2评价异质性。结果：纳入了3项随机对照试验共2303名患者，卵圆孔封堵术与药物治疗相比，，主要结局指标分析无统计学异质性(P=0.69, I2=0%)，采用固定效应模型，结果无统计学差异(RR=0.71,95%CI=0.47-1.05,P=0.09)；两种疗法导致的不良事件分析无统计学异质性(P=0.77,I2=0%)，采用固定效应模型进行meta分析，结果无统计学差异(RR=1.08,95%CI=0.93-1.26,P=0.32)。敏感性分析及亚组分析结果提示，卵圆孔大量分流患者及使用Ampatzer封堵器进行PFO封堵术可能降低脑血管事件复发的风险，但结果稳定性较差。结论：目前尚无足够证据证明卵圆孔封堵术预防隐源性脑梗死/TIA复发优于药物治疗，两种疗法安全性相当。
[Abstract]:Objective: to evaluate the safety and efficacy of drug therapy and foramen ovale closure in the prevention of recrudescent cerebral infarction. Methods: Cochrane Clinical trial Registry Center Embase Pubmeda, American Clinical trial Registry Center, China Zhiwang, Wanfang Database, Weipu Chinese Journal Database and Chinese Biomedical Literature Database were searched. All the randomized controlled trials were conducted to compare the difference of prevention rate of recrudescent cerebral infarction between foramen ovale occlusion and drug therapy. The data were statistically analyzed by Review Manager5.2 software. The risk ratio of 95% confidence interval (95% CI) was used to describe the results, and the chi-square test was used to evaluate the heterogeneity of I2. Results: 2303 patients were enrolled in 3 randomized controlled trials. Compared with drug therapy, the main outcome indexes of oval foramen occlusion were analyzed without statistical heterogeneity (P < 0. 69) and I _ (2). The fixed effect model was used. Results there was no statistical difference between RRX 0.71 and 95. There was no significant difference in the analysis of adverse events caused by the two treatments. No statistical heterogeneity was found in the analysis of adverse events. The fixed effect model was used for meta analysis. There was no statistical difference in the CI0.93-1.26P0.32. The results of sensitivity analysis and subgroup analysis suggested that the patients with massive shunt of foramen ovale and PFO occluder with Ampatzer occluder might reduce the risk of recurrence of cerebrovascular events, but the stability of the results was poor. Conclusion: there is not enough evidence to prove that foramen ovale occlusion is superior to drug therapy in preventing the recurrence of cryptogenic cerebral infarction / TIA, and the safety of the two methods is the same.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R743.3

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