经导管主动脉瓣植入术治疗二叶式主动脉瓣重度狭窄有效性及安全性的Meta分析

发布时间：2018-05-30 14:03

  本文选题：经导管主动脉瓣植入术 + 主动脉瓣狭窄　； 参考：《临床心血管病杂志》2017年06期

【摘要】：目的:应用Meta分析的方法来评价经导管主动脉瓣膜植入术(TAVI)治疗二叶式主动脉瓣(BAV)重度狭窄的有效性及安全性。方法:通过计算机检索建库至2016年8月PubMed、The Cochrance Library、Embase、中国知网和万方数据库中发表的有关TAVI治疗BAV重度狭窄的疗效与安全性的前瞻性队列研究。同时,手工检索纳入文献的参考文献,查找相关研究。筛选文献、提取资料和评估纳入研究的质量后,采用STATA12软件进行荟萃分析。结果:纳入5项前瞻性队列研究,共2244例患者。NOS评分最高为8分,最低为7分,说明纳入文献质量较好。荟萃分析显示:所绘制的漏斗图显示散点均匀分布于中线两侧,Begg及Egger检验显示P值均0.05,提示各项研究无明显发表偏倚。与非BVA狭窄组相比较,BAV狭窄组瓣膜置入成功率(RR1.019,95%CI0.982~1.057,P=0.327)、平均跨瓣压差(SMD0.004,95%CI0.194~0.186,P=0.969)、30d死亡率(RR1.211,95%CI0.525~2.794,P=0.653)、30d复合终点事件发生率(RR1.096,95%CI0.684~1.757,P=0.703)、瓣周漏(≥2级)发生率(RR1.365,95%CI 0.959~1.943,P=0.084)、起搏器植入率(RR0.836,95%CI0.517~1.352,P=0.465)、严重血管并发症发生率(RR1.085,95%CI 0.401~2.936,P=0.872)及致命性出血发生率(RR0.632,95%CI0.296~1.348,P=0.235)差异均无统计学意义。结论:对于不适合进行外科手术的BAV重度狭窄患者,TAVI是可行、安全和有效的。
[Abstract]:Objective: to evaluate the efficacy and safety of transcatheter aortic valve implantation (TAVI) in the treatment of severe two-lobe aortic valve stenosis by Meta analysis. Methods: a prospective cohort study on the efficacy and safety of TAVI in the treatment of severe BAV stenosis, published in the Cochrance Library Embase, China Zhiwang and Wanfang databases, was searched by computer until Aug. 2016. At the same time, manual retrieval into the literature references, to find relevant research. After screening the literature, extracting the data and evaluating the quality of the research, the meta-analysis was carried out with STATA12 software. Results: in 5 prospective cohort studies, 2244 patients had the highest score of 8 and the lowest of 7, indicating that the quality of the literature included was good. The meta-analysis showed that the scattered points were evenly distributed on both sides of the midline by the funnel diagram and the Egger test showed P value of 0.05, indicating that there was no obvious publication bias in all studies. 涓庨潪BVA鐙�绐勭粍鐩告瘮杈�,BAV鐙�绐勭粍鐡ｈ啘缃�鍏ユ垚鍔熺巼(RR1.019,95%CI0.982~1.057,P=0.327),骞冲潎璺ㄧ摚鍘嬪樊(SMD0.004,95%CI0.194~0.186,P=0.969),30d姝讳骸鐜，

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