药物涂层球囊与药物洗脱支架治疗冠状动脉分叉病变的Meta分析

Meta analysis of drug coating balloon and drug eluting stent for coronary artery bifurcation

目的探讨及评价药物涂层球囊对比药物洗脱支架治疗冠状动脉分叉病变的疗效差异.方法利用PubMed(文献服务检索系统)、EMBASE(医学文摘数据库)、中国知网、OVID生物医学等数据库对截止到2021年12月底发表且与本次研究主题相关的文献进行检索,并利用Rvemen5.3软件对文献数据进行分析.结果最终12篇文献被采纳,总例数1271例.Meta分析结果:药物涂层球囊组的晚期管腔丢失(RR=-0.00,95%CI:-0.03~0.02,P=0.65)、心肌梗死(RR=1.23,95%CI:0.52~2.89,P=0.64)两个指标与DES组无统计学差异;主要不良心脏事件(RR=1.23,95%CI:0.52~2.89,P=0.001),靶病变再次血运重建(RR=0.41,95%CI:0.24~0.72,P=0.002)发生率相比药物洗脱支架组更低,说明药物涂层球囊组治疗冠状动脉分叉病变临床效果更好.结论当发生冠状动脉分叉病变时,结合临床应用效果,建议使用药物涂层球囊进行治疗.

Objective To explore and evaluate the efficacy difference between drug-coated balloon comparative drug eluting stent for the treatment of coronary artery bifurcation lesions.Methods PubMed(Document Service Retrieval System),EMBASE(Medical Abstracts Database),CNKI,OVID Biomedicine and other databases were used to search the literature published by the end of December 2021 and related to this research topic,and use Rvemen5.3 The software analyzes the literature data.Results In the end,12 articles were accepted,with a total of 1271 cases.Meta-analysis results:late lumen loss in drug—coated balloon group(RR=-0.00,95%CI:-0.03-0.02,P=0.65),myocardial infarction(RR=1.23,95%CI:0.52-2.89,P=0.64).There was no significant difference between the two indicators and the DES group,major adverse cardiac events(RR=1.23,95%CI;0.52-2.89,P-0.001),target pathogenesis once again reconstruction(RR=0.41,95%CI:0.24-0.72,P=0.002).The incidence was lower than that of the drug eluting bracket group,indicating that the drug coating balloon group is better to treat coronary forked lesions.Conclusion When a coronary aorta branch lesion occurs,combined with clinical application effects,it is recommended to use drug coating balloon for treatment.