两种冠状动脉旁路移植术对平均70岁以上患者近期疗效比较的Meta分析

SHORT-TERM THERAPEUTIC EFFECT OF TWO TYPES OF CORONARY ARTERY BYPASS GRAFTING IN PATIENTS AGED 70 YEARS OR ABOVE:A META-ANALYSIS

目的比较停跳冠状动脉旁路移植术(On-Pump CABG)与不停跳冠状动脉旁路移植术(Off-Pump CABG)对平均70岁以上患者随访1月内的临床疗效。方法检索万方、维普、中国知网、PubMed、Web of Science、Science Direct和Cochrane Library等中英文数据库中关于Off-Pump CABG(试验组)与On-Pump CABG(对照组)临床随机对照试验,对两组患者的病死率及心肌梗死、脑卒中、肾功能衰竭4项指标进行Meta分析。结果共有13项随机对照试验16966例患者纳入本次Meta分析。试验组患者病死率、心肌梗死、脑卒中和肾功能衰竭的发生率均明显低于对照组(P<0.05)。病死率的OR值为0.76,95%CI=0.65~0.90;心肌梗塞发生率的OR值为0.77,95%CI=0.62~0.96;脑卒中的发生率的OR值为0.64,95%CI=0.45~0.89;肾功能衰竭的发生率的OR值为0.59,95%CI=0.47~0.73。结论Off-Pump CABG对平均70岁以上患者随访1月内的疗效优于On-Pump CABG。

Objective To investigate the therapeutic effect of on-pump coronary artery bypass grafting(CABG)versus off-pump CABG in patients aged 70 years or above within the 1-month follow-up.Methods Chinese and English databases including Wanfang Data,VIP,CNKI,PubMed,Web of Science,Science Direct,and Cochrane Library were searched for randomized controlled trials on on-pump CABG(trial group)and off-pump CABG(control group),and a meta-analysis was performed for the four indices of fatality rate,myocardial infarction,stroke,and renal failure.Results A total of 13 randomized controlled trials involving 16966 patients were included in this meta-analysis.Compared with the control group,the trial group had significantly lower fatality rate and incidence rates of myocardial infarction,stroke,and renal failure(P<0.05).The odds ratio(OR)value of fatality rate was 0.76(95%CI=0.65-0.90),the OR value of myocardial infarction was 0.77(95%CI=0.62-0.96),the OR value of stroke was 0.64(95%CI=0.45-0.89),and the OR value of renal failure was 0.59(95%CI=0.47-0.73).Conclusion Off-pump CABG has a better therapeutic effect than on-pump CABG in patients aged 70 years or above within the 1-month fol-low-up.