摘要
目的评价他汀类药物对非心脏血管手术围手术期的有效性。方法计算机检索PubMed、The cochrane library、EMBASE、中国学术期刊全文数据库(CNKI)、万方数据库及维普中文科技期刊数据库等收集他汀类药物对非心脏血管手术围手术期有效性的随机对照试验,检索时限均从建库至2018年6月。由2位评价者按照纳入和排除标准筛选文献、提取资料并进行方法学质量评价,然后采用Revman 5.3软件进行Meta分析,共纳入7篇随机对照试验(RCT),共1 659例患者,其中他汀治疗组850例,常规治疗对照组809例。结果 Meta分析结果显示:心肌梗死发生率(RR=0.57,95%CI:0.35～0.95,P=0.03),心肌损伤发生率(RR=0.69,95%CI:0.52～0.92,P=0.01)两项指标比较,两组差异均有统计学意义。结论与安慰剂比较,行非心脏血管手术患者围手术期加用他汀类药物能够有效降低心肌梗死发生率、心肌损伤发生率。
Objective To evaluate the effectiveness of statins in the perioperative period of noncardiac vascular surgery.Methods Computer search for PubMed,the cochrane library,EMBASE,Chinese Academic Journal Full-text Database(CNKI),Wanfang Database and Weipu Chinese Sci-tech Journal Database.Randomized controlled trials to collect the efficacy of statins in perioperative period of non-cardiovascular surgery.The time limit is from the establishment of the library to June 2018.The two reviewers screened the literature,extracted the data,and performed methodological quality assessment according to the inclusion and exclusion criteria,and then used Revman 5.3 software for meta-analysis.A total of 7 randomized controlled trials(RCTs)were included,with a total of 1 659 patients,including 850 in the statin group and 809 in the conventional control group.Results The results of meta-analysis showed that the incidence of myocardial infarction(RR=0.57,95%CI:0.35 ～0.95,P =0.03),the incidence of myocardial injury(RR =0.69,95%CI:0.52 ～0.92,P =0.01).Comparison of the two indicators,the difference between the two groups were statistically significant.Conclusion Compared with placebo,perioperative addition of statins to noncardiac vascular surgery patients can effectively reduce the incidence of myocardial infarction and myocardial injury.
引文
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