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目的:评价血栓抽吸联合血小板糖蛋白Ⅱb/Ⅲa受体拮抗剂(GPI)在急性STEMI患者直接PCI中的临床疗效。方法:计算机检索The Cochrane Library、PubMed、CNKI、万方数据库等关于急性STEMI患者直接PCI中应用血栓抽吸联合GPI的随机对照试验,按纳入与排除标准独立选择试验、资料提取和质量评价,对同质研究采用RevMan 5.2软件进行Meta分析。结果:最终纳入10项研究,共1 223例患者,分为试验组与对照组。Meta分析结果显示:与对照组相比,试验组主要心血管不良事件发生率(OR=0.55,95%CI:0.35~0.88,P=0.01)明显降低;TIMI 3级血流(OR=4.01,95%CI:2.55~6.32,P<0.01)及ST段回落情况(OR=2.55,95%CI:1.89~3.44,P<0.01)得到明显改善;试验组左室射血分数(OR=7.22,95%CI:6.03~8.42,P<0.01)优于对照组。结论:血栓抽吸联合GPI的应用可以明显降低急性STEMI患者MACE发生率,增加TIMI 3级血流,改善术后ST段回落情况及左室射血分数。
Objective: To evaluate the clinical efficacy of thrombus aspiration combined with platelet glycoprotein Ⅱb / Ⅲa receptor antagonist (GPI) in direct PCI of acute STEMI patients. Methods: The randomized controlled trials of thrombus aspiration combined with GPI in direct PCI of acute STEMI patients were searched by Computer. The Cochrane Library, PubMed, CNKI and Wanfang database were independently selected for inclusion and exclusion criteria, data extraction and quality evaluation. Homogeneous studies using RevMan 5.2 software for meta-analysis. Results: In the end, 10 studies were included, totally 1 223 patients were divided into experimental group and control group. Meta-analysis showed that the incidence of major adverse cardiovascular events (OR = 0.55, 95% CI: 0.35-0.88, P = 0.01) in the experimental group was significantly lower than that in the control group; TIMI grade 3 blood flow (OR = 4.01, (OR = 2.52, 95% CI: 2.55-6.32, P <0.01) and ST-segment depression (OR = 2.55,95% CI: 1.89-3.44, P <0.01). The left ventricular ejection fraction (OR = 7.22, 95% CI: 6.03 ~ 8.42, P <0.01) than the control group. Conclusion: The application of thrombus aspiration combined with GPI can significantly reduce the incidence of MACE in acute STEMI patients, increase TIMI grade 3 blood flow, and improve postoperative ST-segment depression and left ventricular ejection fraction.