经导管主动脉瓣膜植入术与外科主动脉瓣膜置换术的疗效及安全性比较的Meta分析
发布时间：2018-10-26 10:23
【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)治疗重度主动脉瓣狭窄患者的有效性及安全性。方法SAVR为治疗重度主动脉瓣狭窄的标准方法,本文探讨TAVI是否不劣于SAVR。在Pubmed, The Cochrance Library, Embase三个国外主要的数据库中进行计算机检索,获取已公开发表的有关TAVI与SAVR治疗重度主动脉瓣狭窄患者的队列研究。通过文献筛选后对TAVI及SAVR术后30天全因死亡率、术后长期全因死亡率、术后心血管疾病死亡率、心肌梗死发生率、脑卒中发生率资料进行提取,然后运用STATA 11软件对所得数据进行Meta分析。结果本篇文章最终纳入2009年至2014年的17个临床非随机对照研究及3个临床随机对照研究,总计5805例样本,其中TAVI 2844例,SAVR2961例。进行异质性分析显示各研究间统计学异质性小,均选用固定效应模型进行Meta分析。结果显示：TAVI组与SAVR组术后30天全因死亡率无明显差异(RR 1.09,95%CI 0.89 to 1.33, P=0.426);在平均18.7个月的随访中术后长期全因死亡率无明显差异(RR 1.05,95%CI 0.97 to 1.13,P=0.209)；在平均21.8个月的随访中术后心脏病死亡率无明显差异(RR0.92,95%CI 0.69 to 1.23, p=0.582);在平均15.1个月的随访中术后心肌梗死发生率无明显差异(RR 1.13,95%CI 0.51 to2.49, p=0.763);在平均12.5个月的随访中术后脑卒中发生率无明显差异(RR 1.11,95%CI0.76 to1.63,P=0.581)。结论重度主动脉瓣狭窄患者TAVI与SAVR在术后30天近期生存率及平均18.7个月的长期生存率相似。TAVI与SAVR在术后心脏病死亡率及术后主要不良心脑血管事件上无显著差异。重度主动脉瓣狭窄患者TAVI不劣于SAVR,TAVI是一种有效且安全的治疗方法。
[Abstract]:Objective to evaluate the efficacy and safety of transcatheter aortic valve implantation (TAVI) in the treatment of severe aortic stenosis by Meta analysis. Methods SAVR is the standard method for the treatment of severe aortic stenosis. This article discusses whether TAVI is not inferior to SAVR.. A cohort study on the treatment of severe aortic stenosis with TAVI and SAVR was carried out in three foreign databases of Pubmed, The Cochrance Library, Embase. The data of TAVI and SAVR mortality after 30 days, long-term mortality, cardiovascular disease mortality, myocardial infarction rate and stroke rate were extracted by literature screening. Then the data are analyzed by Meta using STATA 11 software. Results this article was included in 17 clinical non-randomized controlled trials and 3 clinical randomized controlled trials from 2009 to 2014. A total of 5805 samples were collected, including 2844 cases of TAVI and 2844 cases of SAVR2961. The heterogeneity analysis showed that the statistical heterogeneity was small and fixed effect model was used for Meta analysis. The results showed that there was no significant difference in total cause mortality between TAVI group and SAVR group 30 days after operation (RR 1.09 to 1.33, P = 0.426). There was no significant difference in long-term mortality rate between two groups (RR 1.05 卤95 CI 0.97 to 1.13p 0.209) during an average follow-up of 18.7 months. There was no significant difference in postoperative heart disease mortality (RR0.92,95%CI 0.69 to 1.23, p0. 582) during an average of 21. 8 months follow-up. There was no significant difference in the incidence of myocardial infarction (RR 1.1395 CI 0.51 to2.49, p0. 763) during an average of 15. 1 months follow-up. There was no significant difference in the incidence of postoperative stroke (RR 1.1195 CI 0.76 to1.63,P=0.581) during an average of 12.5 months follow-up. Conclusion the short-term survival rate and the average long-term survival rate of TAVI and SAVR in patients with severe aortic stenosis were similar at 30 days and 18.7 months, respectively. There was no significant difference between TAVI and SAVR in postoperative heart disease mortality and major adverse cardiovascular and cerebrovascular events. TAVI is not inferior to SAVR,TAVI in patients with severe aortic stenosis.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R654.2
本文编号：2295412
[Abstract]:Objective to evaluate the efficacy and safety of transcatheter aortic valve implantation (TAVI) in the treatment of severe aortic stenosis by Meta analysis. Methods SAVR is the standard method for the treatment of severe aortic stenosis. This article discusses whether TAVI is not inferior to SAVR.. A cohort study on the treatment of severe aortic stenosis with TAVI and SAVR was carried out in three foreign databases of Pubmed, The Cochrance Library, Embase. The data of TAVI and SAVR mortality after 30 days, long-term mortality, cardiovascular disease mortality, myocardial infarction rate and stroke rate were extracted by literature screening. Then the data are analyzed by Meta using STATA 11 software. Results this article was included in 17 clinical non-randomized controlled trials and 3 clinical randomized controlled trials from 2009 to 2014. A total of 5805 samples were collected, including 2844 cases of TAVI and 2844 cases of SAVR2961. The heterogeneity analysis showed that the statistical heterogeneity was small and fixed effect model was used for Meta analysis. The results showed that there was no significant difference in total cause mortality between TAVI group and SAVR group 30 days after operation (RR 1.09 to 1.33, P = 0.426). There was no significant difference in long-term mortality rate between two groups (RR 1.05 卤95 CI 0.97 to 1.13p 0.209) during an average follow-up of 18.7 months. There was no significant difference in postoperative heart disease mortality (RR0.92,95%CI 0.69 to 1.23, p0. 582) during an average of 21. 8 months follow-up. There was no significant difference in the incidence of myocardial infarction (RR 1.1395 CI 0.51 to2.49, p0. 763) during an average of 15. 1 months follow-up. There was no significant difference in the incidence of postoperative stroke (RR 1.1195 CI 0.76 to1.63,P=0.581) during an average of 12.5 months follow-up. Conclusion the short-term survival rate and the average long-term survival rate of TAVI and SAVR in patients with severe aortic stenosis were similar at 30 days and 18.7 months, respectively. There was no significant difference between TAVI and SAVR in postoperative heart disease mortality and major adverse cardiovascular and cerebrovascular events. TAVI is not inferior to SAVR,TAVI in patients with severe aortic stenosis.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R654.2
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相关期刊论文 前1条
1 葛均波;周达新;潘文志;王箴;葛雷;潘翠珍;罗红;丁文军;王春生;陈纪言;方唯一;傅国胜;霍勇;王伟民;张大东;;经皮主动脉瓣植入术一例及其操作要点[J];中国介入心脏病学杂志;2010年05期
，本文编号：2295412
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