ST段抬高型心肌梗死患者介入术后心血管不良事件危险因素的Meta分析

doi:10.3761/j.issn.0254-1769.2020.04.012

摘要/Abstract

摘要： 目的明确ST段抬高型心肌梗死（ST elevation myocardial infarction,STEMI）患者经皮冠状动脉介入治疗（percutaneous coronary intervention,PCI）术后主要心血管不良事件（major adverse cardiovascular events,MACEs）发生的危险因素。方法计算机检索Embase、Medline、Scopus、中国知网、中国生物医学文献数据库、万方、维普等数据库,纳入2008年1月1日—12月31日关于STEMI患者PCI术后MACEs危险因素的文献。2名研究人员独立完成文献筛选、偏倚风险评价及资料提取,并进行Meta分析。结果共纳入35篇文献,包括43 839例患者,有统计学意义的危险因素包括女性（OR=4.17）、高龄（OR=2.84）、红细胞分布宽度≥13%（OR=2.04）、肾功能异常（OR=2.23）、随机血糖≥11 mmol/L（OR=1.82）、非O型血（OR=1.75）、三支病变（OR=1.75）、糖化血红蛋白分数≥5.7%（OR=1.63）、无梗死前胸痛症状（OR=1.56）、症状出现至球囊扩张时间延长（OR=1.48）、高血压（OR=1.27）。结论女性、高龄、红细胞分布宽度≥13%、肾功能异常、随机血糖≥11 mmol/L等是STEMI患者PCI术后MACEs的危险因素。

关键词: ST段抬高型心肌梗死, 经皮冠状动脉介入治疗, 危险因素分析, Meta分析

Abstract: Objective To identify risk factors of major adverse cardiovascular events（MACEs） in ST elevation myocardial infarction（STEMI） patients after percutaneous coronary intervention（PCI）. Methods Embase,Medline,Scopus,CNKI,CBM,WanFang Data,VIP,ProQuest Dissertations and Theses-A&I and Clinical Trials. gov were searched to collect studies from January 1st,2008 to December 31st,2018 on risk factors of MACEs. Study screening,data extraction,quality appraisal and meta-analysis were conducted by 2 reviewers independently. Results 35 studies,involving 43,839 patients were included. The statistically significant risk factors were female（OR=4.17）,advanced age（OR=2.84）,red cell distribution width≥13%（OR=2.04）,abnormal renal function（OR=2.23）,glucose≥11 mmol/L（OR=1.82）,non-O blood type（OR=1.75）,triple-vessel disease（OR=1.75）,glycated hemoglobin fraction≥5.7%（OR=1.63）,painless STEMI（OR=1.56）,longer symptom-onset-to-balloon time（OR=1.48） and hypertension（OR=1.27）. Conclusion The risk factors of MACEs in STEMI after PCI include female,advanced age,red cell distribution width≥13%,abnormal renal function,glucose≥11 mmol/L,non-O blood type,triple-vessel disease,glycated hemoglobin fraction≥5.7%,painless STEMI,longer symptom-onset-to-balloon time and hypertension.

Key words: ST Elevation Myocardial Infarction, Percutaneous Coronary Intervention, Risk Factors Analysis, Meta-Analysis

燕芳红, 刘欢, 蒋文慧. ST段抬高型心肌梗死患者介入术后心血管不良事件危险因素的Meta分析[J]. 中华护理杂志, 2020, 55(4): 542-548.

YAN Fanghong, LIU Huan, JIANG Wenhui. Risk factors of major adverse cardiovascular events in ST elevation myocardial infarction patients after percutaneous coronary intervention：a Meta-analysis[J]. Chinese Journal of Nursing, 2020, 55(4): 542-548.

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