急性心肌梗死心肺复苏后尿激酶溶栓荟萃分析

Meta analysis of urokinase thrombolytic therapy after cardiopulmonary resuscitation in acute myocardial infarction complicating cardiac arrest.

目的分析急性心肌梗死并发心脏骤停心肺复苏后尿激酶溶栓的疗效和安全性。方法在维普中文科技期刊全文数据库巾，检索有关AMI并发CA在CPR后尿激酶静脉溶栓的临床对照研究文献（1991～2006年），汇总分析溶栓与否对并发CA的AMI患者的影响．并比较CPR后溶栓与普通溶栓（未发生CA）之间在疗效和安全性方面的差异。结果共有10篇文献人选。CPR后尿激酶静脉溶栓的冠脉再通率明显高于普通溶栓（81．7％VS64.3％，P〈0．005），其出血发生率与普通溶栓类似。与未溶栓相比．尿激酶溶栓能显著提高AMI并发CA患者的存活出院率（70．1％VS26．9％，P〈0．005）。结论AMI心肺复苏术后尿激酶溶栓疗效显著且相对安全。

Objective To analysis the efficacy and safety of urokinase thrombolytic therapy after cardiopulmonary resuscitation in acute myocardial infarction（AMI） complicating cardiac arrest（CA）. Methods All clinical studies were retrieved from Chinese scientific and technical periodical database of www.cqvip.com on urokinase thrombolytic therapy in AMI complicating CA compared to non-thrombolysitic groups from 1991 to 2006. A metal analysis was performed to evaluate the effect of thrombolysis and non-thrombolysis in AMI complicating CA. The difference between AMI complicating CA and AMI without CA was analyzed in the efficacy and safety of thrombolysis. Results Ten clinical control studies were included. The repeffusion rate after intravenous urokinase of AMI patients complicating CA was obviously higher than that of AMI patients without CA （81.7% vs 64.3% ,P〈0.005）, the bleeding rate was similar to that of AMI patients without CA. Compared to non-thrombolysis, urokinase thrombolytic therapy after CPR could significantly improved the survival discharge rate of AMI patients complicating CA（70.1% vs 26.9% ,P 〈0.005）. Conclusion Urokinase thrombolytic therapy after CPR is effective and relatively safe in AMI patients complicating CA.