经导管主动脉瓣置入术治疗老年重度主动脉瓣狭窄有效性和安全性的Meta分析

发布时间：2018-07-12 13:53

本文选题：经导管主动脉瓣置入术 + 标准疗法　；参考：《新疆医科大学》2017年硕士论文

【摘要】：目的:系统评价经导管主动脉瓣置入术(TAVI)与标准疗法(药物治疗或经皮球囊主动脉瓣成形术,ST)相比,治疗老年重度主动脉瓣狭窄(AS)患者的有效性和安全性。方法:检索PubMed、EMbase、Cochrane Library、万方数据库和中国知网数据库,自建库时间至2016年9月发表的相关文献,同时检索纳入文章的参考文献。按纳入及排除标准筛选文献,提取纳入文献相关资料。应用RevMan 5.3(Copenhagen:The Nordic Cochrane Centre,The Cochrane Collaboration,2013)软件进行数据分析。结果:共纳入6项研究,包含1603例患者。Meta分析显示,与ST相比,TAVI可以显著降低患者6个月死亡率[风险比(RR)=0.51,95%可信区间(CI):0.39~0.66,P0.01]及12个月死亡率(RR=0.58,95%CI:0.48~0.71,P0.01)。但1个月死亡率无显著统计学差异(RR=1.09,95%CI:0.73~1.64,P=0.67)。并且,TAVI术后1个月内患者脑血管事件发生率(RR=4.24,95%CI:1.64~10.99,P0.01)及出血发生率(RR=3.75,95%CI:1.77~7.92,P0.01)均显著增高。结论:经导管主动脉瓣置入术与标准疗法相比,虽增高术后1个月内脑血管事件及出血发生率,但可降低6个月及12个月死亡率。
[Abstract]:Objective: to evaluate the efficacy and safety of transcatheter aortic valve placement (tavi) in elderly patients with severe aortic valve stenosis (as) compared with standard therapy (drug therapy or percutaneous balloon aortic valvuloplasty St). Methods: the relevant literatures published from the time of establishment of the database were retrieved from the database of PubMedus EMbase Cochrane Library, Wanfang Database and China knowledge Network database, and the references of the articles were also searched at the same time. According to the inclusion and exclusion criteria to screen the literature, extraction and inclusion of literature related materials. Use RevMan 5.3 (Copenhagen: the Nordic Cochrane Centre, the Cochrane collaboration 2013) for data analysis. Results: a total of 6 studies including 1603 patients. Meta-analysis showed that compared with St, tavi significantly reduced 6-month mortality [risk ratio (RR) 0.51 95% confidence interval (CI) 0.390.390.66% P0.01] and 12-month mortality (RRV 0.588% 95% CI0.480.71P0.01). However, there was no significant difference in 1 month mortality (RRX 1.09 卤95CI: 0.73% 1.64% P 0.67). The incidence of cerebrovascular events (RRX 4.2495 CI: 1.6410. 99% P0.01) and bleeding (RRV 3.75% 95% CIW 1.777.92% P0.01) were significantly increased within one month after TAVI. Conclusion: compared with the standard therapy, transcatheter aortic valve implantation can decrease the mortality of 6 months and 12 months, although it can increase the incidence of cerebrovascular events and hemorrhage within 1 month after operation.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R654.2

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