本文選題：卵圓孔未閉 + 隱源性腦梗死��； 參考：《廣西醫(yī)科大學(xué)》2014年碩士論文

【摘要】：目的：對(duì)藥物治療和卵圓孔封堵術(shù)預(yù)防隱源性腦梗死復(fù)發(fā)的安全性和有效性進(jìn)行評(píng)價(jià)。 方法：檢索考克蘭臨床試驗(yàn)注冊(cè)中心、Embase、Pubmed、美國(guó)臨床試驗(yàn)注冊(cè)中心、中國(guó)知網(wǎng)、萬(wàn)方數(shù)據(jù)庫(kù)、維普中文期刊數(shù)據(jù)庫(kù)、中國(guó)生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫(kù)。納入研究設(shè)計(jì)均為隨機(jī)對(duì)照試驗(yàn)，比較卵圓孔封堵術(shù)與藥物治療預(yù)防隱源性腦梗死復(fù)發(fā)率的差異，使用Review Manager5.2軟件對(duì)所提取的數(shù)據(jù)進(jìn)行統(tǒng)計(jì)分析，采用風(fēng)險(xiǎn)比、95%可信區(qū)間、p值描述結(jié)果，卡方檢驗(yàn)與I2評(píng)價(jià)異質(zhì)性。 結(jié)果：納入了3項(xiàng)隨機(jī)對(duì)照試驗(yàn)共2303名患者，卵圓孔封堵術(shù)與藥物治療相比，，主要結(jié)局指標(biāo)分析無(wú)統(tǒng)計(jì)學(xué)異質(zhì)性(P=0.69, I2=0%)，采用固定效應(yīng)模型，結(jié)果無(wú)統(tǒng)計(jì)學(xué)差異(RR=0.71,95%CI=0.47-1.05,P=0.09)；兩種療法導(dǎo)致的不良事件分析無(wú)統(tǒng)計(jì)學(xué)異質(zhì)性(P=0.77,I2=0%)，采用固定效應(yīng)模型進(jìn)行meta分析，結(jié)果無(wú)統(tǒng)計(jì)學(xué)差異(RR=1.08,95%CI=0.93-1.26,P=0.32)。敏感性分析及亞組分析結(jié)果提示，卵圓孔大量分流患者及使用Ampatzer封堵器進(jìn)行PFO封堵術(shù)可能降低腦血管事件復(fù)發(fā)的風(fēng)險(xiǎn)，但結(jié)果穩(wěn)定性較差。 結(jié)論：目前尚無(wú)足夠證據(jù)證明卵圓孔封堵術(shù)預(yù)防隱源性腦梗死/TIA復(fù)發(fā)優(yōu)于藥物治療，兩種療法安全性相當(dāng)。
[Abstract]:Objective: to evaluate the safety and efficacy of drug therapy and foramen ovale closure in the prevention of recrudescent cerebral infarction. Methods: Cochrane Clinical trial Registry Center Embase Pubmeda, American Clinical trial Registry Center, China Zhiwang, Wanfang Database, Weipu Chinese Journal Database and Chinese Biomedical Literature Database were searched. All the randomized controlled trials were conducted to compare the difference of prevention rate of recrudescent cerebral infarction between foramen ovale occlusion and drug therapy. The data were statistically analyzed by Review Manager5.2 software. The risk ratio of 95% confidence interval (95% CI) was used to describe the results, and the chi-square test was used to evaluate the heterogeneity of I2. Results: 2303 patients were enrolled in 3 randomized controlled trials. Compared with drug therapy, the main outcome indexes of oval foramen occlusion were analyzed without statistical heterogeneity (P < 0. 69) and I _ (2). The fixed effect model was used. Results there was no statistical difference between RRX 0.71 and 95. There was no significant difference in the analysis of adverse events caused by the two treatments. No statistical heterogeneity was found in the analysis of adverse events. The fixed effect model was used for meta analysis. There was no statistical difference in the CI0.93-1.26P0.32. The results of sensitivity analysis and subgroup analysis suggested that the patients with massive shunt of foramen ovale and PFO occluder with Ampatzer occluder might reduce the risk of recurrence of cerebrovascular events, but the stability of the results was poor. Conclusion: there is not enough evidence to prove that foramen ovale occlusion is superior to drug therapy in preventing the recurrence of cryptogenic cerebral infarction / TIA, and the safety of the two methods is the same.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類(lèi)號(hào)】：R743.3

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