[1]赵代鑫?胡晓军?谭巨浪?裴畅.基于Meta分析对比药物涂层球囊与药物洗脱支架在细小冠状动脉疾病中的应用[J].心血管病学进展,2022,(1):82-87.[doi:10.16806/j.cnki.issn.1004-3934.2022.01.021]
　ZHAO Daixin,HU Xiaojun,TAN Julang,et al.Comparison of Application of Drug-Coated Balloon and Drug-Eluting Stent in Small Coronary Artery Disease Based on Meta Analysis[J].Advances in Cardiovascular Diseases,2022,(1):82-87.[doi:10.16806/j.cnki.issn.1004-3934.2022.01.021]
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基于Meta分析对比药物涂层球囊与药物洗脱支架在细小冠状动脉疾病中的应用()
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《心血管病学进展》[ISSN:51-1187/R/CN:1004-3934]

卷:
期数:
2022年1期
页码:
82-87
栏目:
出版日期:
2022-01-25

文章信息/Info

Title:
Comparison of Application of Drug-Coated Balloon and Drug-Eluting Stent in Small Coronary Artery Disease Based on Meta Analysis
作者:
赵代鑫1; 2?胡晓军1; 2?谭巨浪1?裴畅1
(1.湖北中医药大学,湖北 武汉 430065;2.湖北中医药大学附属新华医院 湖北省中西医结合医院,湖北 武汉 430015)
Author(s):
ZHAO Daixin1; 2;  HU Xiaojun1; 2;  TAN Julang1;  PEI Chang1
(1.Hubei University of Traditional Chinese Medicine,Wuhan 430015,Hubei,China; 2.Xinhua Hospital of Hubei University of Chinese Medicine,Hubei Provincial?Hospital of Integrated Chinese and Western Medicine,Wuhan 430015,Hubei,China)
关键词:
药物涂层球囊; 药物洗脱支架; 细小冠状动脉疾病; meta分析
Keywords:
Drug-coated balloon; Drug-eluting stent; Small coronary artery disease; Meta analysis
DOI:
10.16806/j.cnki.issn.1004-3934.2022.01.021
摘要:
目的 运用meta分析对比药物涂层球囊（DCB）与药物洗脱支架（DES）在细小冠状动脉疾病中的应用。方法 计算机全面检索CNKI、CBM、PubMed和Embase。检索时间从建库至2021年5月1日，搜集DCB与DES治疗细小冠状动脉疾病的临床随机对照试验。3名研究者独立进行筛选和提取数据，依据Cochrane系统评价手册进行偏倚风险评价，以RevMan 5.4软件进行异质性检验及直接meta分析。结果 共纳入六项随机对照研究，共涉及1 551例患者。meta分析结果显示：最终结果和同期随访第2年：DCB与DES能降低靶血管血运重建（TVR）、心肌梗死（MI）、靶病变血运重建和心源性死亡的发生风险，但二者的差异无统计学意义。同期随访第1年：DCB较DES能显著降低MI（RR＝0.43，95% CI 0.22～0.83，P＝0.01）和TVR（RR＝0.60，95% CI 0.39～0.92，P＝0.02）的发生风险。术后第6个月的血管造影结果：DCB较DES能显著增大最小管腔直径（MD＝﹣0.30，95% CI ﹣0.48～﹣0.11，P＝0.001），减少晚期管腔丢失（MD＝﹣0.21，95% CI ﹣0.26～﹣0.16，P＜0.001）和降低血管狭窄程度（MD＝4.09，95% CI 0.68～7.50，P＝0.02）。结论 DCB较DES可显著减少细小冠状动脉血管病变晚期管腔丢失，增大最小管腔直径和降低血管狭窄程度。心脏不良事件与DES相似，但同期随访第1年，DCB在MI和TVR低于DES。因此笔者认为，DCB在治疗细小冠状动脉疾病方面优于DES。
Abstract:
Objective To compare the application of drug-coated balloons(DCB) and drug-eluting stents(DES) in the treatment of small coronary artery diseases using meta analysis. Methods The computer comprehensively search CNKI,CBM,PubMed,and Embase. The search period is from establishment of the database to May 1,2021. We collected clinical randomized controlled trials of drug-coated balloons vs. drug-eluting stents in the treatment of small coronary artery disease. Three researchers independently screened and extracted data. We conducted bias risk assessment based on the Cochrane System Evaluation Manual. RevMan 5.4 software was used for heterogeneity test and direct meta analysis. Results Six randomized controlled studies were included,involving a total of 1 551 patients were included. Meta-analysis results showed that the final results and the second year of follow-up:DCB and DES can reduce the risk of target vessel revascularization（TVR）,myocardial infarction（MI）,target lesion revascularization（TLR）and cardiac death,but the difference between the two is not statistically significant. The first year of follow-up:DCB can significantly reduce MI(RR＝0.43,95% CI 0.22～0.83,P＝0.01) and TVR (RR＝0.60,95% CI 0.39～0.92,P＝0.02) compared with DES . Angiography results in the sixth month after surgery:DCB can significantly increase the minimum lumen diameter(MD＝﹣0.30,95% CI ﹣0.48～﹣0.11,P＝0.001) compared with DES,and reduce late loss in lumen diameter (MD＝﹣0.21,95% CI ﹣0.26～﹣0.16,P＜0.001) and reduce the degree of vascular stenosis(MD＝4.09,95% CI 0.68～7.50,P＝0.02). Conclusion Compared with DES,DCB can significantly reduce the late lumen loss of small coronary vascular disease,increase the minimum lumen diameter and reduce the degree of vascular stenosis. Cardiac adverse events were similar to DES,but at the first year of follow-up,DCB was lower in MI and TVR than DES. Therefore,we believe that DCB is superior to DES in the treatment of small coronary artery diseases

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备注/Memo

备注/Memo:
投稿日期：2021-07-09基金项目：湖北省卫生健康委员会资助项目（ZY2021M070，WJ2021F118）?通信作者：胡晓军，E-mail：hxjsuper@163.com
更新日期/Last Update: 2022-02-18