静脉溶栓联合早期经皮冠状动脉介入治疗急性ST段抬高型心肌梗死的荟萃分析

被引：31

作者：

张步春

周志文

侯磊

张戟

李伟明

徐亚伟

机构：

[1] 同济大学附属第十人民医院心内科

来源：

中华医学杂志 | 2011年 / 28期

关键词：

心肌梗死; 血栓溶解疗法; 血管成形术,经腔,经皮冠状动脉; 荟萃分析;

D O I：

暂无

中图分类号：

R542.22 [];

学科分类号：

摘要：

目的系统评价静脉溶栓联合早期经皮冠状动脉介入(PCI)治疗急性ST段抬高心肌梗死(24h)的有效性和安全性。方法计算机检索MEDLINE、EMBASE、Elsevier、Cochrane数据库及中国万方、中国知网(CNKI)数据库,收集静脉溶栓联合早期PCI治疗急性ST段抬高心肌梗死的随机对照试验(RCT),2名研究者独立检索和评价相关文献,应用RevMan 5.0和Stata 10.0软件进行数据统计学处理。结果共纳入8项研究(NORDI-STEMI,TRANSFER-AMI,WEST,CARESS-AMI,CAPITAL-AMI,GRACIA-Ⅰ,SIAMIⅢ,PRAGUE-Ⅰ),3157例病人。(1)溶栓后早期PCI治疗组30d复合终点事件低于对照组(RR=0.52,95%CI 0.42～0.65,P<0.001);(2)溶栓后早期PCI治疗组30d非致死性心肌梗死发生率低于对照组(RR=0.57,95%CI 0.40～0.81,P=0.002);(3)溶栓后早期PCI治疗组30d再发心肌缺血发生率低于对照组(RR=0.27,95%CI0.14～0.52,P<0.001);(4)溶栓后早期PCI治疗组30d出血并发症发生率(RR=1.07,95%CI0.78～1.46,P=0.69)、30d心血管性死亡发生率(RR=0.86,95%CI 0.62～1.20,P=0.38),组间比较差异无统计学意义。结论静脉溶栓联合早期PCI治疗急性ST段抬高心肌梗死能够降低30d复合终点事件、非致死性心肌梗死发生率和再发心肌缺血发生率,而不增加出血和死亡风险。

引用

页码：1961 / 1965

共 7 条

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