中国胸心血管外科临床杂志

中国胸心血管外科临床杂志

胺碘酮预防冠状动脉旁路移植术术后心房颤动有效性的系统评价和 Meta 分析

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目的 评价胺碘酮预防冠状动脉旁路移植术术后心房颤动的有效性。 方法 计算机检索中国生物医学文献数据库(CBM,1978年 1 月~2017 年 8 月)、中国学术期刊全文数据库(CNKI,1987 年 1 月~2017 年 8 月)、维普数据库(VIP,1989 年 1 月~2017 年 8 月)、万方数据库(1998年 1 月~2017 年 8 月)及 PubMed 数据库(1989 年 1 月~2017 年 8 月)。按纳入及排除标准进行文献筛选,并提取资料。用改良的 Jadad 量表评价文献质量。采用 Cochrane 协作网提供的 Rev Man5.3 进行 Meta 分析。 结果 共纳入 19 篇文献,均为随机对照试验,共 2 817 例患者。Jadad 评分高质量文献 16 篇,低质量 3 篇。Meta 分析显示:与安慰剂组(对照组)相比,胺碘酮(试验组)降低冠状动脉旁路移植术术后心房颤动的发生率[RR=0.37,95% CI(0.28,0.50),P<0.000 01]。亚组分析:与安慰剂组(对照组)相比,胺碘酮不同给药时间及给药方式对动脉旁路移植术术后心房颤动有显著影响(P<0.05)。 结论 与安慰剂相比,胺碘酮有效地降低冠状动脉旁路移植术术后心房颤动的发生率。

Objective To evaluate efficacy of amiodarone in the prevention of atrial fibrillation after coronary artery bypass grafting. Methods CBM (from January 1978 to August 2017), CNKI (from January 1987 to August 2017), VIP (from January 1989 to August 2017), Wanfang (from January 1998 to August 2017) and PubMed (from January 1989 to August 2017) databases were searched. The articles were selected based on the inclusion and exclusion criteria. Quality of articles was assessed by improved Jadad scale. Statistical analysis was performed using RevMan 5.3. Results There were 19 articles meeting inclusion criteria including 2 817 patients and all were randomized controlled trial (RCT). There were 16 articles with high quality and 3 articles with low quality by improved Jadad scale. Compared with the placebo, amiodarone had a significant effect on reducing the incidence of atrial fibrillation after coronary artery bypass grafting (RR=0.37, 95% CI 0.28 to 0.50, P<0.000 01) and different administration models and time of amiodarone had effect on the atrial fibrillation after aterial bypass grafting (P<0.05). Conclusion Compared with the placebo, amiodarone is effective in reducing the incidence of atrial fibrillation after coronary artery bypass grafting.

关键词: 冠状动脉旁路移植术; 心房颤动; 胺碘酮

Key words: Coronary artery bypass grafting; atrial fibrillation; amiodarone

引用本文: 付嘉玉, 沈春健, 高顺, 刘炜, 刘超, 谢不敏, 吴文哲, 葛尧. 胺碘酮预防冠状动脉旁路移植术术后心房颤动有效性的系统评价和 Meta 分析. 中国胸心血管外科临床杂志, 2018, 25(5): 420-426. doi: 10.7507/1007-4848.201708040 复制

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