入院血糖对经PCI治疗的急性ST段抬高型心肌梗死患者预后价值的Meta分析

镐振选; 刘洋; 王丹利; 吴雷; 韩文杰; 刘恒亮

doi:10.13201/j.issn.1001-1439.2015.05.008

入院血糖对经PCI治疗的急性ST段抬高型心肌梗死患者预后价值的Meta分析

- 南方医科大学郑州人民医院心内科(郑州, 450000)

详细信息

作者简介:
刘恒亮,E-mail:liuhengliang66@163.com

中图分类号: R542.2

收稿日期: 2014-09-27

Admission glucose in diabetic patients with ST-segment elevation myocardial infarction treated with percutaneous coronary intervention:a Meta-analysis

- Department of Cardiology, the People's Hospital of Zhengzhou, Southern Medical University, Zhengzhou, 450000, China

Received Date: 27 September 2014

摘要

摘要: 目的:探讨高入院血糖对经皮冠状动脉介入治疗(PCI)的急性ST段抬高型心肌梗死(STEMI)患者早期和晚期死亡风险的预后作用。方法:通过检索PubMed、EMBASE、Web of Science、the Cochrane Library和中国生物医学文献数据库(CBM)获取相关文献,使用固定效应模型或随机效应模型合并各研究的死亡相对危险度(RR)及其可信区间(CI)。结果:7篇文献报告了早期或晚期死亡率。Meta结果显示,高入院血糖组的早期死亡风险是低入院血糖组的2.00倍(95%CI:1.40~2.86)。高入院血糖组的晚期死亡风险(基于早期生存者)仍然稍高于低入院血糖组(RR=1.24,95%CI:0.63~2.43),但并没有统计学意义。结论:在PCI时代,既往糖尿病史合并高入院血糖的STEMI患者,其早期死亡风险显著高于入院血糖非增高组,入院血糖可以作为短期预后的评价因素;但其基于早期生存者的晚期死亡风险与低血糖组并无显著性差异,其预后意义需谨慎对待。
- ST段抬高型心肌梗死 /
- 经皮冠状动脉介入治疗 /
- 糖尿病 /
- 死亡风险
Abstract: Objective:For diabetic patients,impaired admission glucose(AG) is thought to significantly increase risk on both early and late death with ST-segment elevation myocardial infarction(STEMI) following by percutaneous coronary intervention(PCI);however,some reports contradict these relationships.We therefore conducted a systematic literature review and meta-analysis to evaluate such relationship.Method:Pubmed,EMBASE,Web of Science,Cochrane Library databases and China Biology Medicine disc(CBM) were systematically searched to identify all related prospective cohort studies.The unadjusted and adjusted relative risks(RRs) with their 95% confidence interval(CI) were pooled quantitatively using random-effects or fixed-effect models as appropriate.Result:7articles were identified to report the early outcome events and late outcome events.The pooled unadjusted relative risks of early outcome events indicated patients who had glucose concentrations had a 2.00-fold(95%CI,1.40-2.86) higher early mortality.The pooled unadjusted relative risk of late outcome events indicated patients who had glucose concentrations had a 1.24-fold(95% CI 0.63-2.43) higher late mortality based on inhospital or 30-day survivors.Conclusion:In the era of PCI,for patients with previous history of diabetes,the present meta-analysis demonstrates that impaired admission glucose may be an effective prognostic marker of significantly increased risk on early death.In terms of long-term outcomes based on early survival,high admission glucose has no significant increase on risk of death.
- ST-segment elevation myocardial infarction /
- percutaneous coronary intervention /
- diabetes /
- death risk

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参考文献(16)

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