摘要
目的系统评价急性心肌梗死(AMI)后早期氧疗的疗效。方法计算机检索PubMed、EMbase、The Cochrane Library(2015年11期)和CBM数据库,搜集AMI后早期氧疗的相关随机对照试验(RCT),检索时限均从建库至2015年11月。由2名评价者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用Rev Man5.3软件进行Meta分析。结果共纳入7个RCT,共1 388例患者。Meta分析结果显示:氧疗组和对照组患者的病死率[OR=1.12,95%CI(0.57,2.20),P=0.75]、主要心血管事件(MACCE)发生率[OR=1.00,95%CI(0.46,2.18),P=1.00]、住院期间心律失常发生率[OR=1.01,95%CI(0.45,2.24),P=0.98]和心源性死亡发生率[OR=0.53,95%CI(0.17,1.69),P=0.28]的差异均无统计学意义。但氧疗组的再发心肌梗死发生率明显高于对照组[OR=5.73,95%CI(1.47,22.31),P=0.01],平均住院时间明显长于对照组[MD=1.28,95%CI(1.10,1.47),P<0.000 01],且差异具有统计学意义。结论氧疗用于治疗AMI疗效不明确且有增加再发心肌梗死、延长平均住院时间的可能。受纳入研究数量和质量限制,上述结论尚需开展更多高质量研究予以验证。
Objective To systematically review the efficacy and safety of early oxygen therapy for patients with acute myocardial infarction（AMI）. Methods We searched databases including PubMed, EMbase, The Cochrane Library（Issue 11, 2015） and CBM from inception to October 2015, to collect randomized controlled trials（RCTs） about early oxygen therapy for patients with AMI. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed by using Rev Man 5.3 software. Results A total of 7 RCTs involving 1 388 patients were included. The results of meta-analysis showed that, there were no significant differences between the oxygen therapy group and the control group in mortality（OR=1.12, 95%CI 0.57 to 2.20, P=0.75）, the incidence of major cardiovascular and cerebrovascular events（MACCE）（OR=1.00, 95%CI 0.46 to 2.18, P=1.00）, the incidence of arrhythmia（OR=1.01, 95%CI 0.45 to 2.24, P=0.98） and the incidence of cardiac death（OR=0.53, 95%CI 0.17 to 1.67, P=0.28）. But, the oxygen therapy group had higher risk of recurrent myocardial infarction（OR=5.50, 95%CI 1.44 to 20.99, P=0.01） and longer average hospital length of stay（MD=1.28, 95%CI 1.10 to 1.47, P〈0.000 1）. Conclusion The efficacy of early oxygen therapy for patients with AMI is not clear, even may increase the risk of recurrent myocardial infarction and the average hospital length of stay. Due to the limited quantity and quality of include studies, more high quality studies are needed to verify the above conclusion.
出处
《中国循证医学杂志》
CSCD
2016年第3期304-310,共7页
Chinese Journal of Evidence-based Medicine
关键词
急性心肌梗死
氧疗
系统评价
META分析
随机对照试验
Acute myocardial infarction
Oxygen therapy
Systematic review
Meta-analysis
Randomized Controlled trial
