心肌灌注显像评价冠心病患者远期预后的Meta分析

Evaluation of the long-term prognosis of coronary heart disease with myocardial perfusion imaging： a Meta-analysis

目的系统评价核素MPI参数（SRS、SSS及其差值SDS和LVEF）对冠心病患者远期预后评估的临床价值。方法计算机辅以人工检索Medline、EMbase、Cochrane、知网、万方、维普等数据库关于MPI评价冠心病患者远期预后公开发表的文献，检索期间为2003年1月至2015年1月。按纳入和排除标准筛选文献，提取数据，采用Revman5．3软件进行Meta分析。应用Stata12．0软件绘制倒漏斗图，Begg’s检验进一步判定发表偏倚的可能性。结果共纳入11个研究，11634例患者。Meta分析结果显示：SRS[风险比（nn）=1．14，95％CI：1．11～1．18；z=8．53，P〈0．01]、SSS（HR=1．05，95％C1：1．05-1．23：z=2．34，P=0．02）、SDS（HR=1．14，95％CI：1．01—1．10；z=3．07，P：0．002）和LVEF（HR：0．95，95％CI：0．93～0．97；z=4．53，P〈0．01）评价冠心病患者远期预后有统计学意义。结论核素MPI功能参数评价冠心病患者远期预后有较高的临床价值。

Objective To analyze multiple functional parameters of radionuclide MPI （ SRS, SSS, SDS and LVEF） in order to evaluate the long-term prognosis in patients with coronary heart disease （CHD）. Methods The published articles on MPI for long-term prognosis in patients with CHD were searched in Medline, the Excerpta Medica Database （EMbase）, Cochrane and China National Knowledge Infrastructure （CNKI） , Wangfang Database, Vip Database from January 2003 to January 2015 with inclusion and exclu- sion criteria. The meta-analysis was conducted using RevMan 5.3 software. Stata 12.0 software was used to draw the funnel plot and to determine the possibility of publication bias by Begg＇s test. Results A total of 11 studies and 11 634 patients were ultimately included. The meta-analysis indicated that the SRS （hazard ratio （HR）= 1.14, 95% CI： 1.11-1.18; z=8.53, P〈0.01）, SSS（HR= 1.05, 95% CI： 1.05-1.23; z=2.34, P= 0.02）, SDS（HR=1.14, 95% CI： 1.01-1.10; z=3.07, P=O.002） and LVEF （HR=0.95, 95% CI： 0.93- 0. 97 ; z = 4.53, P〈0.01 ） had statistical significance for the prognosis of CHD. Conclusion MPI functional parameters are significantly valuable for the evaluation of long-term prognosis in patients with ariD.