非ST段抬高急性冠脉综合征的介入治疗

Interventional syndrome in patients with non ST segment elevation acute coronary

目的探讨非ST段抬高急性冠脉综合征的介入治疗的临床效果。方法在计算机中检索中国生物医学文献数据库、中国期刊全文数据库及万方数据库从建库至2013年3月1日的有关非ST段抬高急性冠脉综合征介入治疗的相关文献,对检索的文献进行筛选、评价。最后对符合研究目的的文献数据录入协作网提供的Rev-Man5.0软件进行Meta分析。结果本次分析共纳入5项对照实验,Meta分析显示,非ST段抬高急性冠脉综合征(NSTE-ACS)介入治疗与保守治疗6个月心脏不良事件(MACE)情况为[OR=0.23,95%CI(0.14,0.36),P<0.00001];NSTE-ACS介入治疗与保守治疗肌钙蛋白(Tn)阴性亚组情况为[OR=0.86,95%CI(0.70,1.07),P=0.18];NSTE-ACS介入治疗与保守治疗肌钙蛋白(Tn)阳性亚组情况为[OR=0.57,95%CI(0.48,0.66),P<0.00001];NSTE-ACS介入治疗与保守治疗后发生心肌梗塞情况为[OR=2.16,95%CI(1.62,2.89),P<0.00001];NSTE-ACS介入治疗与保守治疗后6个月病死情况为[OR=0.76,95%CI(0.61,0.95),P=0.02]。结论 NSTE-ACS介入治疗比保守治疗6个月MACE显著减低,且治疗Tn阳性亚组根据疗效。此外,介入治疗在病发心肌梗死和病死率方面均比保守治疗低。介入治疗NSTE-ACS值得临床借鉴运用。

Objective To investigate the clinical effect of interventional therapy for non ST segment elevation acute coronary syndrome.Methods to search the Chinese biomedical literature database,China journal full text database and Wanfang database from inception to March 1,2013 in computer related non ST segment elevation acute coronary syndrome related literature of interventional treatment,screening,evaluation of retrieval literature.At the end of the line with the literature data entry collaboration research purpose Rev-Man5.0software provided by Meta analysis.Results the analysis included 5 control experiments,Meta analysis,non ST segment elevation acute coronary syndrome(NSTE-ACS)in the treatment and conservative treatment for 6 months,adverse cardiac events(MACE)to[OR=0.23,95%CI(0.14,0.36),P<0.00001];NSTE-ACS interventional therapy and conservative treatment of cardiac troponin I(Tn)negative sub group[OR=0.86,95%CI(0.70,1.07),P=0.18];NSTE-ACS interventional therapy and conservative treatment of cardiac troponin I(Tn)positive subgroup of[OR=0.57,95%CI(0.48,0.66),P<0.00001];NSTE-ACS interventional therapy and conservative treatment after myocardial infarction(1.62,2.89)for[OR=2.16,95%CI,P<0.00001];NSTEACS interventional therapy and 6 months after conservative treatment for[OR=0.76,95% CI(mortality 0.61,0.95),P=0.02].Conclusion interventional treatment of NSTE-ACS were significantly lower than those in the conservative treatment of 6 months for MACE,and the treatment of Tn positive subgroups according to curative effect.In addition,interventional treatment of myocardial infarction and mortality rate in the disease than the conservative treatment of low.Interventional therapy of NSTE-ACS is worthy of clinical use.