[1]钟宇媚 吴佳妮 丘政源 谭惠羽.静脉动脉-体外膜肺氧合支持治疗暴发性心肌炎患者的临床结局：一项系统评价和meta分析[J].心血管病学进展,2026,(3):270.[doi:10.16806/j.cnki.issn.1004-3934.2026.03.016]
　ZHONG Yumei,WU Jiani,QIU Zhengyuan,et al.Clinical Outcomes of VenoarterialExtracorporeal Membrane Oxygenation Support in Patients with Fulminant Myocarditis: A Systematic Review and Meta-Analysis[J].Advances in Cardiovascular Diseases,2026,(3):270.[doi:10.16806/j.cnki.issn.1004-3934.2026.03.016]
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静脉动脉-体外膜肺氧合支持治疗暴发性心肌炎患者的临床结局：一项系统评价和meta分析()

《心血管病学进展》[ISSN:51-1187/R/CN:1004-3934]

卷:
期数:
2026年3期
页码:
270
栏目:
论著
出版日期:
2026-03-25

文章信息/Info

Title:
Clinical Outcomes of VenoarterialExtracorporeal Membrane Oxygenation Support in Patients with Fulminant Myocarditis: A Systematic Review and Meta-Analysis
作者:
钟宇媚 吴佳妮 丘政源 谭惠羽
(中山大学附属第七医院,广东 深圳 518107)
Author(s):
ZHONG Yumei; WU Jiani; QIU Zhengyuan; TAN Huiyu
(The Seventh Affiliated Hospital,Sun Yat-sen University,Shenzhen 518107,Guangdong ,China)
关键词:
暴发性心肌炎; 体外膜肺氧合; 静脉动脉-体外膜肺氧合; 死亡率; 撤机成功率; 系统评价; Meta分析
Keywords:
Fulminant myocarditis; Extracorporeal membrane oxygenation;  Venoarterialextracorporeal membrane oxygenation; Mortality; Weaning success rate; Systematic review; Meta-analysis
DOI:
10.16806/j.cnki.issn.1004-3934.2026.03.016
摘要:
目的 系统评价并量化静脉动脉-体外膜肺氧合（VA-ECMO）治疗暴发性心肌炎（FM）患者的临床结局。方法 系统检索国内外数据库，检索时限自各数据库建库起至2025年1月，纳入报道VA-ECMO治疗FM结局的单组研究；依据预设标准进行文献筛选与质量评估，提取基础特征及主要结局。采用随机或固定效应模型进行meta分析，以计算合并效应量及95%CI，并进行亚组分析和敏感性分析。通过χ?检验与I?检验评估异质性，倒漏斗图、Egger’s与Begg’s检验判断发表偏倚。结果 共纳入10项国内外高质量研究，基于随机效应模型，采用logit转换进行meta合并分析，结果显示VA-ECMO治疗暴发性心肌炎患者的合并死亡率为38% (95%CI 28%~48%) ，文献间存在较高异质性（I?=93%，P＜0.001）。亚组分析显示各亚组内异质性均显著（I?＞80%，P＜0.05）；不同研究国家之间合并死亡率差异无统计学意义（P=0.621）；不同治疗方案、研究设计、研究质量之间合并死亡率差异有统计学意义（P＜0.05）。共6篇文献报道了撤机结果，纳入312例患者，采用随机效应模型分析显示合并撤机成功率为78% (95%CI 65%~87%)，文献间存在较高异质性（ I?=90%，χ?=48.920，P＜0.001）。Egger’s和Begg’s检验均未发现明显发表偏倚（t=0.471、Z=1.100，P＞0.05）。结论 现有证据支持VA-ECMO可在FM的救治中显著改善短期结局，体现为较低的合并死亡率与较高的撤机成功率。
Abstract:
Objective To systematically evaluate and quantify the clinical outcomes of venoarterialextracorporeal membrane oxygenation(VA-ECMO) in patients with fulminant myocarditis(FM). Methods Domestic and international databases were systematically searched from inception to January 2025 for single-arm studies reporting outcomes of VA-ECMO in FM. Literature screening and quality assessment were performed according to predefined criteria. Baseline characteristics and main ending were extracted. Meta-analysis was conducted using random or fixed effect models to calculate pooled effect sizes and 95% CI,with subgroup and sensitivity analyses. Heterogeneity was assessed by χ? and I? tests; publication bias was evaluated by inverted funnel chart,Egger’s and Begg’s tests. Results A total of 10 high-quality domestic and international studies were included. Based on a random-effects model with logit transformation for meta-analysis,the pooled mortality rate of VA-ECMO in patients with FM was 38% (95%CI 28% ～48%),with substantial heterogeneity among studies(I?=93%,P＜0.001). Subgroup analyses showed significant heterogeneity within each subgroup(I?＞80%,P＜0.05). There was no statistically significant difference in pooled mortality rates between countries (P=0.621),while differences between treatment strategies,study designs,and study quality were statistically significant(P＜0.05). Six studies reported weaning outcomes,including 312 patients. A random-effects model showed a pooled weaning success rate of 78%(95%CI65%～87%),with high heterogeneity(I?=90%,χ?=48.920,P＜0.001). Both Egger’s and Begg’s tests indicated no significant publication bias(t=0.471,Z=1.100,P＞0.05). Conclusion Current evidence supports that VA-ECMO can significantly improve short-term outcomes in the treatment of FM,as reflected by a lower pooled mortality rate and a higher weaning success rate

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更新日期/Last Update: 2026-07-03