急诊与择期PCI 对急性心肌梗死患者 左室重构影响的Meta 分析

Influence of emergent and elective percutaneous coronary intervention on ventricular remodeling in acute myocardial infarction: a Meta-analysis

摘要:

目的 综合分析急诊与择期经皮冠状动脉介入治疗（PCI）对急性心肌梗死（AMI）患者左室重 构及左心功能的影响。方法 检索CNKI、万方、维普、Web of Science、the Cochrane Library 及Pubmed 等数据 库，查找公开发表的关于急诊与择期PCI 对AMI 患者左室重构及左心功能影响的相关文献；提取急诊组与择期 组研究例数，以及与研究指标相关的均数及标准差等基本信息，运用Stata 12.0 软件合并分析急诊与择期PCI 对AMI 患者左室重构及左心功能的影响。结果 急诊与择期PCI 对AMI 患者左心室舒张末期内径（LVEDD） 合并标准化均数差（SMD）为-0.627（95%CI：-0.767，-0.487）（P <0.05）。不同处置方式对左室射血分数（LVEF） 的合并SMD 为0.570（95%CI ：0.414，0.726），差异有统计学意义（P <0.05）。结论 急诊较择期PCI 对AMI 患 者LVEDD、LVEF 有改善，可抑制左心室进一步扩大，有效改善左心功能及左心室收缩功能。

Abstract:

Objective To analyze the effect of emergent and elective percutaneous coronary intervention (PCI) on left ventricular remodeling and left ventricular function in patients with acute myocardial infarction (AMI). Methods The databases including CNKI, Wanfang Data, VIP, Web of Science, the Cochrane Library and PubMed were searched for the literature about influence of emergent and selective PCI on ventricular remodeling and left ventricular function in AMI patients. The basic information such as the cases of emergency group and selective group, and the mean and standard deviation of research-related indicators was extracted and analyzed by Meta Stata12.0 software. Results Meta analysis of the effect of emergent and elective PCI on LVEDD in AMI patients showed the combined value of standardized mean difference (SMD) was -0.627 (95% CI: -0.767, -0.487) and the difference was statistically significant (P < 0.05). As to the effect of emergent and elective PCI on LVEF in the AMI patients, the combined SMD value was 0.570 (95%CI: 0.414, 0.726) and the difference was statistically significant (P < 0.05). Conclusions Emergent PCI is better than elective PCI in the improvement of LVEDD and LVEF of AMI patients, and it can inhibit left ventricular enlargement and improve left heart function and left ventricular systolic function.