血塞通注射液对急性心肌梗死经皮冠状动脉介入术后患者心功能影响的Meta分析

Influence of Xuesaitong Injection on heart function in patients with acute myocardial infarction after percutaneous coronary intervention:a Meta-analysis

目的评价血塞通注射液对急性心肌梗死经皮冠状动脉介入术(PCI)后患者心功能的影响。方法计算机检索PubMed、EMbase、The Cochrane Library、WanFang Data、VIP、CBM和CNKI数据库,检索血塞通注射液联合常规西药治疗急性心肌梗死PCI后患者的随机对照试验(RCT),检索时限为2000年1月1日至2020年9月30日。由2名研究者独立筛选文献,提取资料,并评价纳入研究的偏倚风险。采用RevMan 5.4软件进行Meta分析。结果共纳入9个RCTs,共939例患者(分为对照组和治疗组)。结果显示:在常规应用西药基础上联合血塞通注射液,可显著提高介入术后AMI患者的左室射血分数(MD=5.07,95%CI:2.37~7.77,P=0.0002),降低脑钠肽水平(MD=-78.79,95%CI:-95.77~-62.00,P<0.0001);治疗组超敏C反应蛋白(MD=-2.68,95%CI:-4.85~-0.51,P=0.02)和肿瘤坏死因子-α(MD=-5.48,95%CI:-8.99~-1.98,P=0.002)水平较对照组明显下降。结论与单纯西药常规治疗相比,联合使用血塞通注射液可改善急性心肌梗死PCI术后患者的心功能,降低炎症因子水平。

Objective To review the influence of Xuesaitong Injection on heart function in patients with acute myocardial infarction(AMI)after percutaneous coronary intervention(PCI).Methods The databases of PubMed,EMbase,The Cochrane Library,WanFang Data,VIP,CBM and CNKI were retrieved to search randomized controlled trials(RCTs)related to Xuesaitong Injection combined with routine Western medication in treating AMI patients after PCI.The retrieval time was from Jan.1,2000 to Sept.30,2020.The literatures were screened,data was extracted and risk of bias in included RCTs was reviewed by 2 researchers independently.A Meta-analysis was conducted by using RevMan 5.4 software.Results There were totally 9 RCTs included involved 939 patients(divided into control group and treatment group).The results of Meta-analysis showed that routine Western medication combined with Xuesaitong Injection increased significantly left ventricular ejection fraction(MD=5.07,95%CI:2.37~7.77,P=0.0002)and decreased brain natriuretic peptide level(MD=-78.79,95%CI:-95.77~-62.00,P<0.0001).The levels of high sensitivity C-reactive protein(MD=-2.68,95%CI:-4.85~-0.51,P=0.02)and tumor necrosis factor-α(MD=-5.48,95%CI:-8.99~-1.98,P=0.002)decreased significantly in treatment group compared with control group.Conclusion Compared with only routine Western medication,Xuesaitong Injection combined with Western medication can improve heart function and reduce inflammatory factor level in AMI patients after PCI.