發(fā)布時(shí)間：2018-05-11 17:52

  本文選題：心肌梗死 + 尿激酶型纖溶酶原激活物��； 參考：《中國全科醫(yī)學(xué)》2016年17期

【摘要】：目的探討國產(chǎn)重組人尿激酶原治療急性心肌梗死(AMI)的有效性和安全性。方法計(jì)算機(jī)檢索Pub Med、EMBase、Cochrane Library、中國知網(wǎng)、維普網(wǎng)、萬方數(shù)據(jù)知識(shí)服務(wù)平臺(tái)等數(shù)據(jù)庫中已發(fā)表的觀察國產(chǎn)重組人尿激酶原治療AMI安全性和有效性的文獻(xiàn),時(shí)間限定為建庫至2015年9月。由兩名評(píng)價(jià)員獨(dú)立進(jìn)行文獻(xiàn)篩選和質(zhì)量評(píng)價(jià),按預(yù)先設(shè)計(jì)的表格提取資料,包括第一作者、發(fā)表時(shí)間、治療時(shí)間、年齡、樣本量、劑量及評(píng)價(jià)指標(biāo)。納入文獻(xiàn)首先進(jìn)行異質(zhì)性分析,分類變量采用比值比(OR值)及其95%CI為合并效應(yīng)量。結(jié)果共納入10篇文獻(xiàn),AMI患者875例,方法學(xué)質(zhì)量評(píng)價(jià)均為B級(jí)。國產(chǎn)重組人尿激酶原治療AMI患者再通率〔OR=2.63,95%CI(1.95,3.54)〕、完全再通率〔OR=2.85,95%CI(2.09,3.89)〕高于尿激酶,30 d主要不良心血管事件(MACE)發(fā)生率〔OR=0.42,95%CI(0.27,0.65)〕、輕微出血發(fā)生率〔OR=0.52,95%CI(0.33,0.81)〕、出血發(fā)生率〔OR=0.41,95%CI(0.28,0.62)〕低于尿激酶,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。國產(chǎn)重組人尿激酶原與尿激酶治療AMI患者嚴(yán)重出血發(fā)生率比較,差異無統(tǒng)計(jì)學(xué)意義〔OR=0.24,95%CI(0.05,1.12),P=0.07〕。結(jié)論與尿激酶相比,國產(chǎn)重組人尿激酶原治療AMI患者血管再通率高,MACE發(fā)生率低,出血并發(fā)癥少。
[Abstract]:Objective to evaluate the efficacy and safety of domestic recombinant human urokinase in the treatment of acute myocardial infarction (AMI). Methods A computer search was carried out to search the published literatures on the safety and efficacy of domestic recombinant human urokinase in the database of Pub Medsite, China knowledge Network, Wiplnet and Wanfang data knowledge Service platform for the treatment of AMI. The time limit was to build the database until September 2015. Literature screening and quality evaluation were carried out independently by two evaluators, and the data were extracted according to pre-designed tables, including the first author, time of publication, time of treatment, age, sample size, dose and evaluation index. In the literature, the heterogeneity was analyzed first, and the ratio or (OR) and its 95%CI were used as the combined effect. Results A total of 875 patients with AMI were included in 10 articles. The rate of recanalization of patients with AMI treated by domestic recombinant human urokinase was 1.955 / 3.54 and the rate of complete recanalization was 2.859 / 95 respectively), which was higher than that of urokinase / urokinase for 30 days, the incidence of major adverse cardiovascular events was higher than that of OR0.4295CI0.270.650.The incidence of slight hemorrhage was 0.330.81. The incidence of hemorrhage was lower than that of urokinase (P 0.05). There was no significant difference in the incidence of severe hemorrhage between domestic recombinant human urokinase and urokinase in AMI patients. Conclusion compared with urokinase, the rate of vascular recanalization in patients with AMI treated by domestic recombinant human urokinase is higher than that of urokinase, and the incidence of Mace is lower and the complication of bleeding is less.
【作者單位】： 河北醫(yī)科大學(xué)第二醫(yī)院心血管內(nèi)科;
【分類號(hào)】：R542.22

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