瑞替普酶联合还原型谷胱甘肽治疗急性ST段抬高型心肌梗死有效性和安全性的Meta分析

田清山; 范厚德; 黄鹏; 郑振中

doi:10.13201/j.issn.1001-1439.2021.07.010

瑞替普酶联合还原型谷胱甘肽治疗急性ST段抬高型心肌梗死有效性和安全性的Meta分析

- 1. 南昌大学第一附属医院心内科(南昌, 330006);
- 2. 南昌大学第一附属医院超声科;
- 3. 南昌大学公共卫生学院循证医学中心
基金项目:
江西省自然科学基金项目(No:S2020ZRZDB0203)

详细信息

通讯作者: 郑振中,E-mail:greateful@163.com

中图分类号: R541.7

收稿日期: 2020-11-26

Meta-analysis of efficacy and safety of reteplase combined with reduced glutathione in the treatment of acute ST-segment elevation myocardial infarction

- 1. Department of Cardiology, the First Affiliated Hospital of Nanchang University, Nanchang, 330006, China;
- 2. Department of Ultrasound, The First Affiliated Hospital of Nanchang University;
- 3. Evidence-based Medicine Center, School of Public Health, Nanchang University

More Information

Corresponding author: ZHENG Zhenzhong, E-mail: greateful@163.com

Received Date: 26 November 2020

摘要

摘要: 目的:对瑞替普酶(r-PA)联合还原型谷胱甘肽(GSH)治疗急性ST段抬高型心肌梗死(STEMI)的有效性及安全性进行meta分析。方法:通过检索中国生物医学文献数据库、中国知网期刊数据库、万方数据库、维普中文科技期刊数据库、Pubmed、Cochrane Library、Medline数据库,获取从建库至2020年10月8日发表的有关r-PA联合GSH治疗STEMI的随机对照试验。获得和提取资料后依据Cochrane评分表对所纳入文献进行质量评价,使用RevMan5.3及Stata15.1软件进行meta分析。结果:共纳入22篇RCT,STEMI患者共2099例,其中r-PA与GSH联合组共1049例,r-PA单一组共1050例,依据meta分析结果提示,联合组治疗STEMI患者血管再通率(RR=1.15,95%CI1.08~1.24,P<0.01)、临床效果(RR=1.20,95%CI1.13~1.29,P<0.01)、心功能指标如左室射血分数(MD=11.14,95%CI9.84~12.45,P<0.01)、心肌酶谱指标如肌钙蛋白I(MD=-0.77,95%CI-0.82~-0.73,P<0.01)均优于单一组;且不良反应事件总发生率(RR=0.42,95%CI 0.30~0.58,P<0.01)低于单一组。结论:r-PA与GSH联合在治疗STEMI的有效性及安全性均高于单一使用r-PA。
- 瑞替普酶 /
- 还原型谷胱甘肽 /
- 急性ST段抬高型心肌梗死 /
- Meta分析
Abstract: Objective: The efficacy and safety of reteplase(r-PA) combined with reduced glutathione(GSH) in the treatment of acute ST-segment elevation myocardial infarction(STEMI) were analyzed by Meta analysis.Methods: Randomized controlled trials(RCTs) of r-PA combined with GSH in the treatment of STEMI published from the establishment of the database to October 8, 2020 were obtained by searching the Chinese biomedical literature database(CBM), the Chinese knowledge network journal database(CNKI), the Wanfang database, and the VP Chinese sci-tech journal database(VIP), Pubmed, cochrane library, Medline database. After obtaining and extracting the data, the quality of the included literature was evaluated according to the Cochrane scoring table, and meta-analysis was carried out using RevMan 5.3 and stata15.1 software.Results: A total of 22 RCTs and 2099 STEMI patients were included. Of which 1049 were in the combined group of r-PA and GSH, and 1050 were in the single group of r-PA. According to the meta-analysis results, the revascularization rate(RR=1.15, 95%CI 1.08-1.24, P<0.01) and clinical effect(RR=1.20, 95%CI 1.13-1.29, P<0.01), cardiac function indexes such as LVEF(MD=11.14, 95%CI 9.84-12.45, P<0.01), myocardial zymogram indexes such as cTnI(MD=-0.77, 95%CI-0.82-0.73, P<0.01) were better than those of single group. The adverse reactions such as total incidence rate(RR=0.42, 95%CI 0.30-0.58, P<0.01) were lower than those of the single group.Conclusion: The efficacy and safety of r-PA combined with GSH in the treatment of STEMI were higher than that of r-PA alone.
- reteplase /
- reduced glutathione /
- acute ST-segment elevation myocardial infarction /
- Meta-analysis

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