摘要
目的利用Meta分析比较酒精消融术(ASA)与室间隔部分切除术(SM)治疗肥厚型心肌病。方法计算机检索公开发表并收录于Cochrane图书馆、Pubmed、EMbase、中文期刊全文数据库符合纳入标准的临床实验,人工检索纳入研究的参考文献以及心血管相关杂志及会议报告。经过阅读全文、数据提取,对符合质量标准的临床实验进行Meta分析。结果研究共纳入10项临床对照实验,8项研究将ASA与SM术后全因病死率做了比较,结果显示ASA组术后全因病死率高于SM组。7项研究将二者术后植入起搏器情况做了比较,结果显示ASA组术后植入起搏器概率要高于SM组。7项研究对二者经随访后的左心室流出道压力阶差做了比较,结果显示ASA术后左心室流出道压力阶差高于SM组。结论 ASA与SM均为治疗HCM的有效手段,但SM在安全性及中远期疗效方面可能存在一定优势。但仍有待大规模多中心随机对照实验的进一步研究。
Objective To compare the efficacy of alcohol septal ablation（ASA）and septal myotomy（SM） in the treatment of hyper- trophic cardiomyopathy （HCM）. Methods We conducted a systematic computerized literature search of the coehrane collaboration, Pubmed,EMBASE and Chinese journal full- text database. In addition, we supplemented the search with a hand- search of reference lists from included studies and related magazines. After viewing the full - texts and data extractions, we did a meta - analysis. Results Ten clinical trials were included at last. Eight trails, reported all - cause mortality, indicated that patients after ASA had a higher risk of all - cause death mortality. There were 7 trails reported post - intervention pacemaker implantation. These studies indicated that patients after ASA had a higher risk of post - intervention pacemaker implantation. Seven trails reported left left ventricular outflow tract gradient. After analysis, we found that patients of ASA group had a higher left ventricular outflow tract gradient after follow - up. Conclusion Both ASA and SM are effective therapies for HCM. SM may provide lower risk of all - cause mortality and pacemaker treatment compared with ASA. It also provides lower LVOTG after follow - up. But more large randomized clinical trials further comparing two treatments are sug- gested.
出处
《医学研究杂志》
2013年第11期49-54,共6页
Journal of Medical Research
基金
中央高校基本科研业务费专项基金资助项目(2012302020211)
