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目的:比较紫杉醇洗脱支架(PES)与西罗莫司洗脱支架(SES)在糖尿病患者冠状动脉介入治疗中的有效性和安全性。方法:通过Medline、EMBASE、Cochrane library数据库检索2016年5月之前所有相关英文临床随机对照试验(RCTs)。两名评价者利用Jadad评分量表独立评价纳入RCTs的质量并提取资料,评估全因死亡率、支架血栓形成(ST)率及靶病变血运重建(TLR)、靶血管血运重建(TVR)、心肌梗死(MI)、主要不良心脏事件(MACE)发生率,并用Review Manager 5.3软件进行统计分析。结果:最终分析数据来源于9个RCT试验。SES组与PES组全因死亡率、ST率以及MI发生率无统计学差异,但SES组TLR、TVR率以及MACE发生率明显优于PES组(均P<0.05)。结论:从目前临床研究看,对于糖尿病患者,SES的安全性和有效性优于PES。
Objective: To compare the efficacy and safety of paclitaxel-eluting stent (PES) and sirolimus-eluting stent (SES) in the treatment of coronary artery disease in diabetic patients. METHODS: All relevant English RCTs were searched by Medline, EMBASE, Cochrane database before May 2016. Two reviewers independently assessed the quality of inclusion RCTs and extracted data using the Jadad scale to assess all-cause mortality, stent thrombosis (ST) rates, target lesion revascularization (TLR), target vessel revascularization (TVR) , Myocardial infarction (MI) and incidence of major adverse cardiac events (MACE) were measured and analyzed using Review Manager 5.3 software. Results: The final analysis was derived from nine RCTs. There was no significant difference in all-cause mortality, ST rate and MI between SES group and PES group. However, the incidences of TLR, TVR and MACE in SES group were significantly higher than those in PES group (all P <0.05). Conclusion: From the current clinical study, SES is superior to PES in the safety and efficacy of diabetic patients.