血栓抽吸术在急性ST段抬高型心肌梗死患者直接PCI中应用价值的系统评价

Application of aspiration thrombectomy during ST-segment elevation of acute myocardial infarction：a systematic review

摘要:

目的：评价急性ST段抬高型心肌梗死（ST-segment elevation of acute myocardial infarction，STEMI）患者中应用血栓抽吸术的临床疗效。方法：通过在PubMed、CNKI、维普、万方等数据库中检索关于急性STEMI行血栓抽吸联合冠脉支架介入治疗与单纯冠脉支架介入治疗的随机对照研究文献，根据纳入/排除标准筛选文献，利用 RevMan 5.2软件进行Meta分析。结果：共纳入13项研究，通过血栓抽吸联合冠脉支架介入治疗与单纯冠脉支架介入治疗对比，全因死亡率无统计学差异（RR=0.85，95%CI=0.73～1.00，P=0.05），但血栓抽吸组主要心血管不良事件（major adverse cardiovascular events，MACE）事件发生率明显低于单纯PCI组（RR=0.81，95%CI=0.68～0.97，P=0.02）。结论：对于急性STEMI的患者行血栓抽吸能减少患者MACE事件发生率，对远期生存率有着积极作用。

Abstract:

Objective：To systematically review the clinical efficacy of aspiration thrombectomy during ST-segment elevation of acute myocardial infarction（STEMI）. Methods：Literature search was performed among Pubmed，CNKI，VIP，Wangfang databases to search for available randomized control trials comparing aspiration thrombectomy combined with percutaneous coronary intervention（PCI） and single PCI. The Meta-analysis was conducted by using RevMan 5.2 software. Results：Totally 13 trials concerning 11 823 patients were enrolled. There was no statistically significant difference in all-cause mortality between aspiration thrombectomy combined with PCI and single PCI（RR=0.85，95%CI=0.73 to 1.00，P=0.05）. Major adverse cardiac events（MACE） was significantly reduced in aspira－tion thrombectomy combined with PCI than in single PCI（RR=0.81，95%CI=0.68 to 0.97，P=0.02）. Conclusion：Aspiration thrombec－tomy is conducive to reducing MACE.