摘要
目的利用Meta分析法探讨颈动脉内膜剥脱术(CEA)与颈动脉支架植入术(CAS)对颈动脉狭窄治疗1年内死亡和卒中、死亡、卒中、重度再狭窄及闭塞事件发生情况并进行评价。方法制定原始文献的纳入标准、排除标准及检索策略,搜索关于CEA及CAS治疗对颈动脉狭窄的对照研究。应用RevMan4.2.2软件对纳入文献进行定量评价。以优势比(OR值)及双侧95%可信区间(CI)作为效应尺度进行分析。结果纳入本研究的文献共6篇,1037例患者接受CAS治疗,1681例接受CEA治疗,将发生死亡和卒中、死亡、卒中事件统计数据合并;累计1586例接受CAS治疗,2196例接受CEA治疗,进行再狭窄及闭塞的统计数据合并。术后1年内CAS与CEA患者死亡和卒中、死亡、卒中事件发生差异无统计学意义,其OR值分别为0.81(95%CI0.56～1.18)、0.75(95%CI0.47～1.19)、0.78(95%CI0.53～1.16)。CAS患者再狭窄率高于CEA患者[OR=1.99(95%CI1.44～2.74),P<0.05)。结论对于颈动脉狭窄患者,CEA与CAS的1年死亡和卒中、死亡、卒中事件发生无明显差异,CAS术后重度再狭窄及闭塞率为CEA术的1.99倍。由于在缺乏足够数量的随机对照试验的情况下,纳入部分非随机对照试验的Meta分析,使论证强度受到一定的限制,有待更多大样本高质量随机对照试验对本研究结果进一步验证。
Objective To evaluate the 1 year death/stroke,death,stroke,servere restenosis rate of carotid angioplasty and stenting（CAS）,as well as carotid endarterectomy（CEA）to treat carotid stenosis with Meta-analysis.Methods The enroll standard,excluding standard and search strategy of literatures were instituted.Published data of clinical trials comparing the results of CAS and CEA to treat carotid stenosis were analyzed with RevMan 4.2.2 software.The odds ratio（OR）with its 95% confidential interval（CI）was used.Results There were 6 literatures met the inclusion criteria,including 1037 patients treated with CAS,1681 patients treated with CEA.The endpoint of death/stroke,death,stroke were analyzed after 1 year of operation.There were 1586 patients treated with CAS,2196 patients treated with CEA,and their endpoint of servere restenosis was analyzed.After 1 year follow up,the OR value for death/stroke,death,stroke between CAS and CEA was 0.81（95%CI 0.56—1.18）,0.75（95%CI 0.47—1.19）and 0.78（95%CI 0.53—1.16）,respectively.The OR value of servere restenosis between CAS and CEA was 1.99（[95%CI 1.44-2.74],P〈0.05）.Conclusion The rate of death/stroke,death,stroke within 1 year are not statistically different.In the treatment of carotid stenosis diseases compared with CEA,higher restenosis rates happen within 1 year after CAS.For not enough randomized comparison trials,the study includes nonrandomized comparison trials in the Meta analysis,which may reduce the confidence of the result.More randomized comparison trials are expected to refresh the Meta analysis results.
出处
《中国介入影像与治疗学》
CSCD
2011年第1期37-41,共5页
Chinese Journal of Interventional Imaging and Therapy
