急诊与择期PCI对急性心肌梗死患者左室重构影响的Meta分析
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摘要
目的综合分析急诊与择期经皮冠状动脉介入治疗(PCI)对急性心肌梗死(AMI)患者左室重构及左心功能的影响。方法检索CNKI、万方、维普、Web of Science、the Cochrane Library及Pubmed等数据库,查找公开发表的关于急诊与择期PCI对AMI患者左室重构及左心功能影响的相关文献;提取急诊组与择期组研究例数,以及与研究指标相关的均数及标准差等基本信息,运用Stata 12.0软件合并分析急诊与择期PCI对AMI患者左室重构及左心功能的影响。结果急诊与择期PCI对AMI患者左心室舒张末期内径(LVEDD)合并标准化均数差(SMD)为-0.627(95%CI:-0.767,-0.487)(P <0.05)。不同处置方式对左室射血分数(LVEF)的合并SMD为0.570(95%CI:0.414,0.726),差异有统计学意义(P <0.05)。结论急诊较择期PCI对AMI患者LVEDD、LVEF有改善,可抑制左心室进一步扩大,有效改善左心功能及左心室收缩功能。
Objective To analyze the effect of emergent and elective percutaneous coronary intervention(PCI) on left ventricular remodeling and left ventricular function in patients with acute myocardial infarction(AMI). Methods The databases including CNKI, Wanfang Data, VIP, Web of Science, the Cochrane Library and PubMed were searched for the literature about influence of emergent and selective PCI on ventricular remodeling and left ventricular function in AMI patients. The basic information such as the cases of emergency group and selective group, and the mean and standard deviation of research-related indicators was extracted and analyzed by Meta Stata12.0 software. Results Meta analysis of the effect of emergent and elective PCI on LVEDD in AMI patients showed the combined value of standardized mean difference(SMD) was-0.627(95% CI:-0.767,-0.487) and the difference was statistically significant(P < 0.05). As to the effect of emergent and elective PCI on LVEF in the AMI patients, the combined SMD value was 0.570(95%CI: 0.414, 0.726) and the difference was statistically significant(P < 0.05). Conclusions Emergent PCI is better than elective PCI in the improvement of LVEDD and LVEF of AMI patients, and it can inhibit left ventricular enlargement and improve left heart function and left ventricular systolic function.
Objective To analyze the effect of emergent and elective percutaneous coronary intervention(PCI) on left ventricular remodeling and left ventricular function in patients with acute myocardial infarction(AMI). Methods The databases including CNKI, Wanfang Data, VIP, Web of Science, the Cochrane Library and PubMed were searched for the literature about influence of emergent and selective PCI on ventricular remodeling and left ventricular function in AMI patients. The basic information such as the cases of emergency group and selective group, and the mean and standard deviation of research-related indicators was extracted and analyzed by Meta Stata12.0 software. Results Meta analysis of the effect of emergent and elective PCI on LVEDD in AMI patients showed the combined value of standardized mean difference(SMD) was-0.627(95% CI:-0.767,-0.487) and the difference was statistically significant(P < 0.05). As to the effect of emergent and elective PCI on LVEF in the AMI patients, the combined SMD value was 0.570(95%CI: 0.414, 0.726) and the difference was statistically significant(P < 0.05). Conclusions Emergent PCI is better than elective PCI in the improvement of LVEDD and LVEF of AMI patients, and it can inhibit left ventricular enlargement and improve left heart function and left ventricular systolic function.
引文
[1]刘倩,梁传亮,唐志远.左室急性心肌梗死急诊介入治疗与择期介入的对比分析[J].中国医药科学,2012,2(16):187-188.
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[3]邓长金,成威,陈亚锋,等.急性心肌梗死急诊介入治疗对心功能的影响[J].心血管康复医学杂志,2012(1):64-67.
[4]彭艳,程娟.急诊与择期经皮冠状动脉介入术对ST段抬高型心肌梗死患者左室重构及心功能影响的对比研究[J].实用心脑肺血管病杂志,2016,24(5):68-70.
[5]王凤群,王慧峰,张强,等.子母导管在急性心肌梗死患者治疗中的临床应用[J].山西医药杂志,2013(12):1391-1393.
[6]KE D,ZHONG W,FAN L,et al.Delayed versus immediate stenting for the treatment of ST-elevation acute myocardial infarction with a high thrombus burden[J].Coron Artery Dis,2012,23(7):497-506.
[7]徐敏,柏小川,涂清鲜,等.不同治疗方式对急性心肌梗死患者左心功能影响的评价[J].贵州医药,2013,37(6):504-506.
[8]刘卫其,张励庭,黄炫生,等.急性ST段抬高型心肌梗死的急诊介入治疗与择期介入治疗预后对比[J].中国动脉硬化杂志,2011,19(9):781-784.
[9]宋婷婷.急性ST段抬高型心肌梗死急诊介入治疗与择期介入疗效比较[J].系统医学,2017,2(5):48-50.
[10]符琛.急性心肌梗死(ST段抬高型)经不同时间实施介入治疗(急诊、择期)预后效果观察[J].临床合理用药杂志,2017,10(2):96-97.
[11]许云耀,谢志辉,候冬子.急性心肌梗死后行急诊PCI与行择期PCI治疗的近期疗效观察[J].亚太传统医药,2013,9(1):110-111.
[12]金树琦,纪晓玲,蔺雪峰,等.急性心肌梗死介入治疗对患者心功能的影响研究[J].现代诊断与治疗,2014,25(7):1560-1561.
[13]古平,潘波,牟海刚.急诊PCI与择期PCI治疗急性心肌梗死的临床对比分析[J].现代仪器与医疗,2014,20(2):48-50.
[14]陈玉善,张燕,赵秋菊.急诊和择期冠状动脉介入治疗对急性心肌梗死左心室重构和功能的影响[J].中国心血管病研究,2007,5(7):493-495.
[15]孙勇.急诊介入与择期介入对左室急性心肌梗死治疗的影响分析[J].中国临床新医学,2014,7(9):858-860.
[16]严宪才,侯杰.急诊介入与择期介入治疗对急性ST段抬高型心肌梗死临床观察[J].深圳中西医结合杂志,2015,25(15):118-120.
[17]刘志郎,邵亚丽.急诊介入与择期介入治疗急性ST段抬高型心肌梗死的临床及预后效果比较[J].河北医学,2016,22(1):153-155.
[18]吴先明,周建军,何辉,等.急诊与择期经皮冠状动脉介入治疗急性ST段抬高型心肌梗死临床疗效的比较研究[J].实用心脑肺血管病杂志,2015,23(11):46-48.
[19]祁家祥.介入时机对ST段抬高型心肌梗死左心功能的影响分析[J].中国实用医药,2016,11(5):116-117.
[20]陶翠,康健,张妮,等.经皮冠脉介入手术时机的选择对急性心肌梗死患者左室重构及心功能的影响[J].现代生物医学进展,2016,16(26):5172-5174.
[21]张明,杨立绘.心肌梗死早期与择期PCI近期临床预后的对照研究[J].现代医药卫生,2012,28(14):2085-2086.
[22]马骏,邱建,向定成,等.直接和择期冠状动脉介入治疗对急性心肌梗死患者左心室重构和左心功能的影响[J].临床心血管病杂志,2006,22(12):724-726.
[23]PARK H S,KIM C J,YI J E,et al.Contrast volume/raw eGFRratio for predicting contrast-induced acute kidney injury in patients undergoing percutaneous coronary intervention for myocardial infarction[J].Cardiorenal Med,2015,5(1):61-68.
[24]MARTENSSON S,GYRD-HANSEN D,PRESCOTT E,et al.Trends in time to invasive examination and treatment from 2001to 2009 in patients admitted first time with non-ST elevation myocardial infarction or unstable angina in Denmark[J].BMJOpen,2014,4(1):e004052.
[25]MENEVEAU N,SERONDE M F,DESCOTES-GENON V,et al.Immediate versus delayed angioplasty in infarct-related arteries with TIMI III flow and ST segment recovery:a matched comparison in acute myocardial infarction patients[J].Clin Res Cardiol,2009,98(4):257-264.
[2]TANG L,ZHOU S H,HU X Q,et al.Effect of delayed vs immediate stent implantation on myocardial perfusion and cardiac function in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous intervention with thrombus aspiration[J].Can J Cardiol,2011,27(5):541-547.
[3]邓长金,成威,陈亚锋,等.急性心肌梗死急诊介入治疗对心功能的影响[J].心血管康复医学杂志,2012(1):64-67.
[4]彭艳,程娟.急诊与择期经皮冠状动脉介入术对ST段抬高型心肌梗死患者左室重构及心功能影响的对比研究[J].实用心脑肺血管病杂志,2016,24(5):68-70.
[5]王凤群,王慧峰,张强,等.子母导管在急性心肌梗死患者治疗中的临床应用[J].山西医药杂志,2013(12):1391-1393.
[6]KE D,ZHONG W,FAN L,et al.Delayed versus immediate stenting for the treatment of ST-elevation acute myocardial infarction with a high thrombus burden[J].Coron Artery Dis,2012,23(7):497-506.
[7]徐敏,柏小川,涂清鲜,等.不同治疗方式对急性心肌梗死患者左心功能影响的评价[J].贵州医药,2013,37(6):504-506.
[8]刘卫其,张励庭,黄炫生,等.急性ST段抬高型心肌梗死的急诊介入治疗与择期介入治疗预后对比[J].中国动脉硬化杂志,2011,19(9):781-784.
[9]宋婷婷.急性ST段抬高型心肌梗死急诊介入治疗与择期介入疗效比较[J].系统医学,2017,2(5):48-50.
[10]符琛.急性心肌梗死(ST段抬高型)经不同时间实施介入治疗(急诊、择期)预后效果观察[J].临床合理用药杂志,2017,10(2):96-97.
[11]许云耀,谢志辉,候冬子.急性心肌梗死后行急诊PCI与行择期PCI治疗的近期疗效观察[J].亚太传统医药,2013,9(1):110-111.
[12]金树琦,纪晓玲,蔺雪峰,等.急性心肌梗死介入治疗对患者心功能的影响研究[J].现代诊断与治疗,2014,25(7):1560-1561.
[13]古平,潘波,牟海刚.急诊PCI与择期PCI治疗急性心肌梗死的临床对比分析[J].现代仪器与医疗,2014,20(2):48-50.
[14]陈玉善,张燕,赵秋菊.急诊和择期冠状动脉介入治疗对急性心肌梗死左心室重构和功能的影响[J].中国心血管病研究,2007,5(7):493-495.
[15]孙勇.急诊介入与择期介入对左室急性心肌梗死治疗的影响分析[J].中国临床新医学,2014,7(9):858-860.
[16]严宪才,侯杰.急诊介入与择期介入治疗对急性ST段抬高型心肌梗死临床观察[J].深圳中西医结合杂志,2015,25(15):118-120.
[17]刘志郎,邵亚丽.急诊介入与择期介入治疗急性ST段抬高型心肌梗死的临床及预后效果比较[J].河北医学,2016,22(1):153-155.
[18]吴先明,周建军,何辉,等.急诊与择期经皮冠状动脉介入治疗急性ST段抬高型心肌梗死临床疗效的比较研究[J].实用心脑肺血管病杂志,2015,23(11):46-48.
[19]祁家祥.介入时机对ST段抬高型心肌梗死左心功能的影响分析[J].中国实用医药,2016,11(5):116-117.
[20]陶翠,康健,张妮,等.经皮冠脉介入手术时机的选择对急性心肌梗死患者左室重构及心功能的影响[J].现代生物医学进展,2016,16(26):5172-5174.
[21]张明,杨立绘.心肌梗死早期与择期PCI近期临床预后的对照研究[J].现代医药卫生,2012,28(14):2085-2086.
[22]马骏,邱建,向定成,等.直接和择期冠状动脉介入治疗对急性心肌梗死患者左心室重构和左心功能的影响[J].临床心血管病杂志,2006,22(12):724-726.
[23]PARK H S,KIM C J,YI J E,et al.Contrast volume/raw eGFRratio for predicting contrast-induced acute kidney injury in patients undergoing percutaneous coronary intervention for myocardial infarction[J].Cardiorenal Med,2015,5(1):61-68.
[24]MARTENSSON S,GYRD-HANSEN D,PRESCOTT E,et al.Trends in time to invasive examination and treatment from 2001to 2009 in patients admitted first time with non-ST elevation myocardial infarction or unstable angina in Denmark[J].BMJOpen,2014,4(1):e004052.
[25]MENEVEAU N,SERONDE M F,DESCOTES-GENON V,et al.Immediate versus delayed angioplasty in infarct-related arteries with TIMI III flow and ST segment recovery:a matched comparison in acute myocardial infarction patients[J].Clin Res Cardiol,2009,98(4):257-264.