摘要
BackgroundSuboptimal 心肌的灌注在有圣片断举起的病人是普通的经历主要经皮的冠的干预(PPCI ) 的心肌的梗塞(STEMI ) 。而且,它导致增加的梗塞尺寸和死亡率。我们执行了元分析评估渴望 thrombectomy 的角色(在)在心肌的灌注和临床的 outcomes.MethodsPubMed 的改进与 glycoprotein IIb/IIIa 禁止者( GPI )的 intracoronary 管理结合了, Embase ,科学的网,并且中央数据库被寻找因为调查的使随机化的控制试用( RCT )联合了在并且 intracoronary GPI 治疗对在独自一个。利息的结果是在心肌的梗塞的 thrombolysis 心肌的灌注等级( TMPG ),梗塞尺寸()由心脏的磁性的回声成像估计了,左室的喷射部分( LVEF ),主要不利心脏的事件(向)在短期( 1 个月)并且长期( 6-12 月)后续,并且在包含 923 个病人的医院 stay.ResultsEight 试用期间为复杂并发症放血被包括。与相比在独自一个,联合了在, intracoronary GPI 显著地增加了 TMPG 3 流动(RR:1.15, 95% CI:1.04 ~ 1.26 ) ,减少[吝啬的差别(MD ) :-3.46,95% CI:-5.18 到 -1.73], 和改进 LVEF (MD:1.44, 95% CI:0.54 ~ 2.33 ) 。而且, GPI 使用减少了在长期的后续的向的风险(RR:0.60, 95% CI:0.37 ~ 0.98 ) 。在未成年者的发生的二个组之间没有重要差别,主要流血 complications.ConclusionsOur 调查结果显示出那与相比在独自一个,联合了在, intracoronary GPI 治疗导致了改进心肌的灌注,更好心脏的功能,并且没有向的幸存与经历 PPCI 的 STEMI 为病人在长期的后续受益。
Background Suboptimal myocardial reperfusion is common in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI). Furthermore, it results in increased infarct size and mortality rates. We performed a meta-analysis to evaluate the role of aspiration thrombectomy (AT) combined with intracoronary administration of glycoprotein IIb/IIIa inhibitors (GPI) in the improvement of myocardial reperfusion and clinical outcomes. Methods PubMed, Embase, Web of Science, and CENTRAL databases were searched for randomized controlled trials (RCTs) investigating combined AT and intracoronary GPI treatment versus AT alone. Outcomes of interest were thrombolysis in myocardial infarction myocardial perfusion grade (TMPG), infarct size (IS) assessed by cardiac magnetic resonance imaging, left ventricular ejection fraction (LVEF), major adverse cardiac events (MACE) at short-term (〈 1 month) and long-term (6-12 months) follow-up, and bleeding complications during the hospital stay. Results Eight trials involving 923 patients were included. Compared with AT alone, combined AT and intracoronary GPI significantly increased TMPG 3 flow (RR: 1.15, 95% CI: 1.04 to 1.26), reduced IS [mean difference (MD): -3.46, 95% CI: -5.18 to -1.73], and improved LVEF (MD: 1.44, 95% CI: 0.54 to 2.33). Furthermore, GPI use decreased the risk of MACE at long-term follow-up (RR: 0.60, 95% CI: 0.37 to 0.98). There was no significant difference between the two groups in the incidence of minor and major bleeding complications. Conclusions Our findings showed that compared with AT alone, combined AT and intracoronary GPI treatment resulted in improved myocardial reperfusion, better cardiac function, and MACE-free survival benefits at the long-term follow-up for patients with STEMI undergoing PPCI.