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两种冠状动脉旁路移植术对平均70岁以上患者近期疗效比较的Meta分析

SHORT-TERM THERAPEUTIC EFFECT OF TWO TYPES OF CORONARY ARTERY BYPASS GRAFTING IN PATIENTS AGED 70 YEARS OR ABOVE: A META-ANALYSIS

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【作者】 刘旭王海蕊高洪波王伟李贞福

【Author】 LIU Xu;WANG Hairui;GAO Hongbo;WANG Wei;LI Zhenfu;Department of Cardiovascular Surgery, The Affiliated Hospital of Qingdao University;

【通讯作者】 李贞福;

【机构】 青岛大学附属医院心血管外科青岛市中心医院手术室

【摘要】 目的比较停跳冠状动脉旁路移植术(On-Pump CABG)与不停跳冠状动脉旁路移植术(Off-Pump CABG)对平均70岁以上患者随访1月内的临床疗效。方法检索万方、维普、中国知网、PubMed、Web of Science、Science Direct和Cochrane Library等中英文数据库中关于Off-Pump CABG(试验组)与On-Pump CABG(对照组)临床随机对照试验,对两组患者的病死率及心肌梗死、脑卒中、肾功能衰竭4项指标进行Meta分析。结果共有13项随机对照试验16 966例患者纳入本次Meta分析。试验组患者病死率、心肌梗死、脑卒中和肾功能衰竭的发生率均明显低于对照组(P<0.05)。病死率的OR值为0.76,95%CI=0.65~0.90;心肌梗塞发生率的OR值为0.77,95%CI=0.62~0.96;脑卒中的发生率的OR值为0.64,95%CI=0.45~0.89;肾功能衰竭的发生率的OR值为0.59,95%CI=0.47~0.73。结论 Off-Pump CABG对平均70岁以上患者随访1月内的疗效优于On-Pump CABG。

【Abstract】 Objective To investigate the therapeutic effect of on-pump coronary artery bypass grafting(CABG) versus off-pump CABG in patients aged 70 years or above within the 1-month follow-up. Methods Chinese and English databases including Wanfang Data, VIP, CNKI, PubMed, Web of Science, Science Direct, and Cochrane Library were searched for randomized controlled trials on on-pump CABG(trial group) and off-pump CABG(control group), and a meta-analysis was performed for the four indices of fatality rate, myocardial infarction, stroke, and renal failure. Results A total of 13 randomized controlled trials involving 16 966 patients were included in this meta-analysis. Compared with the control group, the trial group had significantly lower fatality rate and incidence rates of myocardial infarction, stroke, and renal failure(P<0.05). The odds ratio(OR) value of fatality rate was 0.76(95%CI=0.65-0.90), the OR value of myocardial infarction was 0.77(95%CI=0.62-0.96), the OR value of stroke was 0.64(95%CI=0.45-0.89), and the OR value of renal failure was 0.59(95%CI=0.47-0.73). ConclusionOff-pump CABG has a better therapeutic effect than on-pump CABG in patients aged 70 years or above within the 1-month fol-low-up.

【基金】 山东省自然科学基金资助项目(ZR2016HQ18)
  • 【文献出处】 精准医学杂志 ,Journal of Precision Medicine , 编辑部邮箱 ,2021年05期
  • 【分类号】R654.2
  • 【下载频次】30
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