鱼油预防冠状动脉旁路移植术后心房颤动疗效的Meta分析

Meta-analysis of fish oil in preventing atrial fibrillation after coronary artery bypass surgery

目的采用Meta分析探讨鱼油在预防冠状动脉旁路移植术后心房颤动的有效性。方法在中国学术期刊网全文数据库、重庆维普数据库、万方数据库、Pumbed、Springerlink、Medline、Cochrane library等数据库中检索相关文献。采用Jadad量表对纳入文献所报道的RCT研究进行方法学质量评价。采用RevMan5.0软件进行数据分析,比较两组的术后心房颤动发生率、住院时间、术后并发症和死亡率,计算合并OR值及95%置信区间,画出森林图。结果最终纳入10篇文献,其中高质量文章共8篇(4~6分),低质量文章共2篇(3分);其中服用鱼油患者(观察组)1724例,未服用鱼油患者(对照组)1710例。Meta分析结果显示,观察组术后心房颤动总发生率和术后住院时间均明显优于对照组(OR=0.780,95%CI=0.670~0.910;OR=-0.580,95%CI=-1.020^-1.090;均P<0.05),术后并发症和死亡率未见明显差异(OR=0.800,95%CI=-0.370~1.700;OR=0.610,95%CI=0.350~1.050;均P>0.05)。亚组分析提示高剂量组术后心房颤动总发生率明显降低(OR=0.530,95%CI=0.350~0.810;P<0.05)。结论鱼油可以减少冠状动脉旁路移植术后心房颤动的发生率和住院时间,且未增加术后并发症和死亡率。

Objective To investigate the effectiveness of fish oil in preventing atrial fibrillation after coronary artery bypass surgery by meta-analysis.Methods Relevant literatures were searched in China National Academic Magazine Database,Chongqing Weipu Database,Wanfang Database,Pumbed,Springerlink,Medline,Cochrane Library and other databases.The Jadad scale was used to evaluate the qualities of the included randomized controlled trials.RevMan5.0 software was used for data analysis,the incidence of postoperative atrial fibrillation,length of hospital stay,postoperative complications and mortality of the two groups were compared.The combined OR(odds ratio)and 95%confidence interval were calculated,and the forest plot was obtained.Results 10 articles were finally included with 8 high-quality articles(4-6 points)and 2 low-quality articles(3 points).A total of 1724 patients who took fish oil were enrolled in the observation group and 1710 who didn’t take fish oil were enrolled in the control group.The results indicated the total incidence of postoperative atrial fibrillation and postoperative hospital stay in the observation group were significantly better than those in the control group(OR=0.780,95%CI=0.670-0.910;OR=-0.580,95%CI=-1.020--1.090;P<0.05).There was no significant difference in postoperative complications and mortality(OR=0.800,95%CI=-0.370-1.700;OR=0.610,95%CI=0.350-1.050;P>0.05).The subgroup analysis indicated that the total incidence of postoperative atrial fibrillation in the high-dose group was significantly reduced(OR=0.530,95%CI=0.350-0.810,P<0.05).Conclusion Fish oil could reduce the incidence of atrial fibrillation and length of hospital stay after coronary artery bypass surgery and would not increase postoperative complications and mortality.