紫杉醇药物洗脱球囊治疗支架内再狭窄的有效性及安全性研究-Meta分析

发布时间：2018-05-30 10:51

  本文选题：支架内再狭窄 + 紫杉醇药物球囊　； 参考：《重庆医科大学》2015年硕士论文

【摘要】：背景随着冠心病治疗逐渐发展,介入手术植入支架的治疗已成为了一种重要的方式。金属裸支架、药物洗脱支架虽然改善了冠心病的治疗效果和预后,也带来了新的问题——支架内再狭窄。药物球囊的出现为解决支架再狭窄带来了希望。与传统的球囊相比,药物洗脱球囊将药物有效持续地扩散入血管壁,减少支架内再狭窄的发生。紫杉醇是其中一种能有效抑制新生内膜增殖的优势药物,因此紫杉醇药物涂层球囊在治疗支架内再狭窄有较大的潜力。目的系统评价紫杉醇药物洗脱球囊(PEB)在临床冠脉支架内再狭窄治疗中的有效性。方法计算机检索PubMed、CNKI、Embase、Cochrone(1990年-2014年)数据库,同时辅以其他的检索,输入关键词,搜索所有关于紫杉醇药物洗脱球囊在支架内再狭窄治疗中应用的随机对照试验(RCT),采用统一的纳入标准后提取数据,用RevMan 5.0进行数据分析研究。结果最终入组了6项临床研究,共801名受试者,Meta分析结果显示：紫杉醇药物洗脱球囊与普通球囊(CB)治疗支架内再狭窄,随访6个月后比较,紫杉醇球囊在以下方面均优于普通球囊：最小管腔直径(OR=0.54；95%CI,0.45-0.64；P0.01),晚期管腔丢失(OR=-0.48；95%CI,-0.60‖-0.36；P0.01),再狭窄率(OR=0.13；95%CI,0.25-0.40；P0.01),靶血管血运重建率(OR=0.15；95%CI,0.06-0.36； P0.01),总死亡率(OR=0.34；95%CI,0.13～0.89,P=0.03),主要心血管事件(MACE)发生率(OR=0.14；95%CI,0.08～0.23,P0.01)。结论本研究结果显示,紫杉醇药物洗脱球囊与普通球囊相比,治疗支架内再狭窄的疗效更好,并可改善预后,作为一种新的冠脉介入治疗选择,紫杉醇药物洗脱球囊显出了潜在的优势。
[Abstract]:Background with the development of coronary heart disease treatment, interventional stent implantation has become an important way. Metallic bare stents and drug-eluting stents not only improve the therapeutic effect and prognosis of coronary heart disease, but also bring new problems-stent restenosis. The appearance of drug balloon offers hope for resolving stent restenosis. Compared with the traditional balloon, the drug elution balloon effectively diffuses the drug into the vascular wall and reduces the incidence of restenosis in the stent. Paclitaxel is one of the dominant drugs which can effectively inhibit the proliferation of neointima, so paclitaxel drug-coated balloon has great potential in the treatment of stent restenosis. Objective to evaluate the efficacy of paclitaxel-eluting balloon in the treatment of intracoronary stent restenosis. Methods the database of CNKIbase Cochrone (1990-2014) was searched by computer, supplemented by other searches, and the key words were entered. To search for all randomized controlled trials about paclitaxel elution balloon in stent restenosis treatment, the data were extracted by unified inclusion standard and analyzed with RevMan 5.0. Results A total of 801 subjects were enrolled in 6 clinical studies. The results of Meta-analysis showed that paclitaxel drug-eluting balloon and conventional balloon CB) were used to treat stent restenosis and were compared after 6 months follow-up. 绱�鏉夐唶鐞冨泭鍦ㄤ互涓嬫柟闈㈠潎浼樹簬鏅�閫氱悆鍥，

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