| 摘要: |
| ［摘要］ 目的 评价国产替罗非班在中国人群糖尿病合并急性心肌梗死经皮冠状动脉介入治疗中的疗效及安全性。方法 计算机检索国内外文献中公开发表的中国人群糖尿病合并急性心肌梗死介入术中应用国产替罗非班的随机对照试验，共纳入19篇文献，2 025例患者，其中替罗非班观察组1 010例，常规治疗对照组1 015例，使用RevMan5.3软件进行Meta分析。结果 与对照组相比，观察组心肌梗死溶栓血流Ⅲ级［RR=1.22，95%CI(1.07，1.39)，P=0.002］改善；术后住院期间、30 d复合心血管事件发生［RR=0.4，95%CI(0.31，0.51)，P<0.00001；RR=0.36，95%CI(0.29，0.45)，P<0.00001］降低；术后1周、30 d左室射血分数［WMD=0.84，95%CI(0.40，1.28)，P=0.0002；WMD=6.25，95%CI(5.25，7.26)，P<0.00001］提高；术后1周、30 d血清BNP［WMD=-53.07，95%CI(-70.69，-35.45)，P<0.00001；WMD=-50.10，95%CI(-60.16，-40.05)，P<0.00001］降低；术后住院期间出血并发症发生［RR=2.04，95%CI(1.40，2.96)，P=0.0002］升高，但未见严重出血病例；术后30 d出血并发症发生［RR=0.90，95%CI(0.65，1.26)，P=0.54］未见明显增高。结论 国产替罗非班在中国人群糖尿病合并急性心肌梗死介入治疗中的疗效显著，且未增加严重出血事件。 |
| 关键词: 替罗非班 糖尿病 急性心肌梗死 经皮冠状动脉介入治疗 Meta分析 |
| DOI：10.3969/j.issn.1674-3806.2017.01.11 |
| 分类号:R 587.1 |
| 基金项目:广西医疗卫生适宜技术研究与开发课题（编号：S29315-04）；南宁市青秀区科学研究与技术开发计划项目（编号：2014S06） |
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| Meta-analysis of the efficacy and safety of home-produced tirofiban during primary percutaneous coronary intervention for patients with diabetic mellitus and acute myocardial infarction |
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MA Chun-lan, WANG Hong, WU Chong-xin, et al.
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Guangxi University of Traditional Chinese Medicine, Nanning 530021, China
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| Abstract: |
| ［Abstract］ Objective To evaluate the efficacy and safety of home-produced tirofiban during primary percutaneous coronary intervention(PCI) for patients with diabetic mellitus(DM) and acute myocardial infarction(AMI) in China.Methods The randomized controlled trials on intervention therapy of DM and AMI with home-produced tirofiban were retrieved by computer. A total of 19 studies were enrolled, including 2 025 patients, in which the tirofiban group contained 1 010 cases and the routine therapy group contained 1 015 cases. Rev-Man 5.3 software was used for meta-analysis.Results Compared with those in the control group, thrombolysis in myocardial infarction(TIMI) Ⅲ flow was improved［RR=1.22,95%CI(1.07, 1.39), P=0.002］; lower incidence of major adverse cardiac events was in the patients during hospitalization and 30 days after PCI ［RR=0.4, 95%CI(0.31, 0.51), P<0.00001; RR=0.36, 95%CI(0.29, 0.45), P<0.00001］; left ventricular ejection fraction(LVEF) was increased［WMD=0.84, 95%CI(0.40,1.28), P=0.0002; WMD=6.25, 95%CI(5.25, 7.26), P<0.00001］ in the patients one week and 30 days after PCI; lower serum BNP ［WMD=-53.07,95%CI(-70.69,-35.45),P<0.00001; WMD=-50.10, 95%CI(-60.16, -40.05), P<0.00001］ was in the patients 7 days and 30 days after PCI and the incidence of bleeding was higher in the tirofiban group［RR=2.04, 95%CI(1.40, 2.96), P=0.0002］. No severe bleeding occurred in both of the two groups. There was no significant difference in bleeding events between the two groups［RR=0.90, 95%CI(0.65, 1.26), P=0.54］ during 30 days after PCI.Conclusion Home-produced tirofiban has significant therapeutic effects on interventional therapy of DM and AMI in Chinese population and has a low incidence of adverse reactions. |
| Key words: Tirofiban Diabetic mellitus Acute myocardial infarction Percutaneous coronary intervention Meta-analysis |
