吸氧对急性心肌梗死患者预后的Meta分析

Efficacy of Oxygen Supplement on Patients with Acute Myocardial Infarction:A Meta-analysis

目的评价吸氧对急性心肌梗死(acute myocardial infarction, AMI)患者预后的影响,以期为临床决策提供证据。方法检索Cochrane Central Register of Controlled Trials、Medline、荷兰医学文摘数据库(the Excerpta Medica Database, EMBASE)、护理学数据库(Cumulative Index to Nursing and Allied Health Literature, CINAHL)、Web of Science、中国知网全文数据库(China National Knowledge Infrastructure, CNKI)、中国生物医学文献数据库(Chinese Biology Medicine disc, CBMdisc)、维普数据库和万方数据库,收集吸氧与空气吸入或定量吸氧对AMI患者预后影响的随机对照试验(randomized controlled trial,RCT)。检索时间均为建库起至2018年5月,以RevMan 5.3软件对所获资料进行统计处理。结果共纳入文献8篇。常规吸氧不能降低AMI患者病死率[OR=1.19,95%CI(0.84,1.68),P=0.33]、阿片类药物使用率[OR=0.97,95%CI(0.52,1.79),P=0.91]、心律失常发生率[OR=1.05,95%CI(0.75,1.47),P=0.76],不能缩小心肌梗死面积[MD=0.14,95%CI(-0.09,0.37),P=0.23]和范围[MD=1.30,95%CI(-0.84,3.44),P=0.23],且存在增加再发心肌梗死的风险[OR=1.80,95%CI(1.01,3.22),P=0.05]。结论常规吸氧无改善AMI患者预后的作用,且存在潜在风险。

Objective To systematically evaluate the efficacy of oxygen supplement on patients with acute myocardial infarction(AMI).Methods Randomized controlled trials(RCTs)related to normobaric oxygen supplement versus room air or titrated oxygen for AMI patients were collected from the Cochrane,Central Register of Controlled Trials,MEDLINE,EMBAS,CINAHL,Web of Science,CNKI,CBM,VIP,and Wanfang database from the inception to May 2018.Meta-analysis was performed by using RevMan 5.3 software.Results Eight RCTs were included.Oxygen supplement did not reduce mortality[OR=1.19,95% CI(0.84,1.68),P=0.33],opiopioid usage[OR=0.97,95% CI(0.52,1.79),P=0.91],arrhythmia[OR=1.05,95% CI(0.75,1.47),P=0.76],myocardial infarction area[MD=0.14,95% CI(-0.09,0.37),P=0.23]and range[MD=1.30,95% CI(-0.84,3.44),P=0.23],There was a increased risk of recurrent myocardial infarction[OR=1.80,95% CI(1.01,3.22),P=0.05].Conclusions Normobaric oxygen does not improve the prognosis of patients with AMI,and there are potential risks.