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目的:分析盐酸替罗非班氯化钠注射液与心血管介入治疗(PCI)术后对急性心肌梗死患者的安全性,为临床治疗提供循征依据。方法:计算机检索Pub Med、万方数据库、中国期刊全文数据库和维普中文数据库、中国知网数据库及Cochrane协作网图书馆,查找盐酸替罗非班氯化钠注射液与心血管介入治疗(PCI)急性心肌梗死(AMI)患者的随机对照试验(RCT),检索时限均为从各数据库建库至2016年12月止,按照纳入与排除标准的筛选文献,提取资料和评价纳入研究的方法学质量后,采用Rev Man 5.3版软件进行Meta分析。结果:共纳入9项随机对照试验,包括920例患者,Meta分析结果显示(1)试验组TIMI分级Ⅲ级者所占比例明显高于对照组(OR=5.73,95%CI(2.99,10.97),P<0.01);(2)不良心脏事件(MACE)的发生率低于对照组(RR=0.24,95%CI(0.14,0.40),P<0.01);(3)但两组出血并发症的发生率之间其差异无统计学意义(RR=1.04,95%CI(0.66,1.64),P>0.05)。结论:在AMI患者治疗中,采用盐酸替罗非班氯化钠注射液联合PCI治疗后,可有效改善患者血流灌注情况,降低并发症与MACE的发生。
Objective: To analyze the safety of sodium tirofiban hydrochloride injection and cardiovascular interventional therapy (PCI) in patients with acute myocardial infarction, and provide evidence for clinical treatment. Methods: The databases of Pub Med, Wanfang Database, Chinese Journal Full-text Database, VIP Chinese Database, CNKI Database and Cochrane Collaboration Library were searched by computer to find the effect of Tirofiban Hydrochloride Injection and Cardiovascular Intervention (PCI) Randomized controlled trials (RCTs) of patients with acute myocardial infarction (AMI) were performed with database searches from each database until December 2016. Screening literature based on inclusion and exclusion criteria, extracting data and assessing the quality of methodology included in the study Afterwards, RevMan version 5.3 software was used for meta-analysis. Results: A total of 9 randomized controlled trials, including 920 patients, were included in the meta-analysis. The results showed that (1) TIMI grade Ⅲ in the experimental group was significantly higher than that in the control group (OR = 5.73,95% CI 2.99,10.97) , P <0.01). (2) The incidence of adverse cardiac events (MACE) was lower than that of the control group (RR = 0.24, 95% CI 0.14,0.40, P <0.01) The difference was not statistically significant (RR = 1.04, 95% CI (0.66, 1.64), P> 0.05). Conclusion: In the treatment of patients with AMI, the use of tirofiban hydrochloride and sodium chloride injection in combination with PCI can effectively improve the patient perfusion and reduce the incidence of complications and MACE.