单双线圈除颤电极临床效果的Meta分析

A Meta analysis of clinical efficiency of single and dual- coil coil defibrillation leads

目的分析单线圈和双线圈除颤电极临床疗效的区别。方法从Cochrane图书馆、Medline、Embase、CBM、VIP,CNKI数据库收集与所有与单线圈和双线圈除颤电极临床效果比较有关的文献,由两位评价者按照相关限定条件进行筛选,筛选出符合纳入标准的文献,采用RevM an5.3进行Meta分析。结果共有13项临床研究6 273例患者纳入分析,其中有6项是随机对照试验,其余为非随机对照试验。阈值测试结果提示单线圈组除颤阈值高于双线圈组（95%CI 0.2~1.29;P=0.007）且单线圈组高除颤阈值发生率高于双线圈组（95%CI 1.29~5.08;P=0.007）,单、双线圈组室速/室颤时心律转复除颤器（ICD）一次除颤成功率没有显著性差异（95%CI 0.96~1.05;P=0.81）,单线圈组总病死率略高于双线圈组,但是差异不显著（95%CI 0.75~1.26;P=0.85）,单、双线圈组电极故障率相比无显著性差异（95%CI 0.48~18.44;P=0.24）。结论单线圈除颤电极在阈值测试中的除颤阈值高于双线圈电极,同时单线圈除颤电极高阈值的发生比率高于双线圈组,两者在室速/室颤时一次除颤成功率、总病死率、电极故障率方面没有显著性差异。但是由于本研究纳入的研究有6项为非随机对照试验,仍需一定量的、高质量的随机对照试验进一步验证。

Objective To analyze the clinical efficiency of single - coil and dual - coil defibrillation lead. Methods From the Cochrane library,Medline,Embase and CBM,VIP,CNKI database,collect relevant literatures on the clinical efficiency comparement of single - coil and dual - coil defibrillation lead by two evaluators,in accordance with the relevant qualification screened out into standard documents,using Rev-Man5. 3 Meta analysis. Results A total of 13 clinical study with 6273 patients were included in the analysis,there are 6 items are randomized controlled trials,the rest is a randomized controlled trial. Threshold test results suggested single - coil defibrillation threshold value was higher than the dual - coil groups（95% CI：0. 2 ~ 1. 29,P = 0. 2）and single - coil set high defibrillation threshold rate was higher than the dual - coil group （95% CI,1. 29 to 5. 08;P = 1. 29）,single and dual - coil group of ventricular tachycardia/ ventricular fibrillation implantable defibrillator （ICD）at a time when there was no significant difference between defibrillation success rate（95% CI：0. 96 ~ 1. 05,P = 0. 96）,single - coil to-tal mortality slightly was higher than that of dual - coil group,but the difference was not significant（95% CI：0. 75 ~ 1. 26,P = 0. 75）,single and dual - coil group lead failure rate had no significant difference（95% CI：0. 48 ~ 18. 44,P = 0. 48）. Conclusion Single - coil defibrillation lead in the threshold test defibrillation threshold value is higher than dual - coil lead,at the same time single - coil of defibrillation lead high threshold percentage is higher than that of dual - coil group,both in the ventricular tachycardia/ ventricular fibrillation when a defibrillation success rate,total mortality,lead failure rate have no significant differences. But 6 items included in the study are randomized controlled trials,therefore, it still need a certain amount,high quality randomized controlled trials to make further verification.