国产替罗非班联合血栓抽吸对急性ST段抬高型心肌梗死患者介入治疗的系统评价

目的评价国产替罗非班联合血栓抽吸对中国人群急性ST段抬高型心肌梗死介入治疗中的有效性及安全性。方法计算机检索Cochrane图书馆临床对照试验资料库（CCTR）、Pubmed、Embase、万方数据库、中国学术期刊全文数据库（CNKI）、维普数据库（VIP）。筛选中英文文献及其参考文献，检索日期截至2013年2月。收集国产替罗非班联合血栓抽吸治疗心肌梗死介入治疗的随机对照试验（RCT），由2名评价者按纳入与排除标准独立选择试验、评价质量并交叉核对，而后对同质研究采用RevMan5．0软件进行Meta分析。结果纳入6项文献共649例患者，使用RevMan5．0软件进行Meta分析。Meta分析结果显示：与对照组比较国产替罗非班联合血栓抽吸可减少无复流发生率（OR=0．23，95％CI：0．12—0．24，P〈0．01），减少术后主要不良心血管事件发生率（OR：0．37，95％CI：0．19～0．75，P=0．005）。结论现有临床研究证据显示：国产替罗非班联合血栓抽吸对中国人群急性sT段抬高心肌梗死介入治疗疗效显著，且不艮反应发生率较低。

A Meta-analysis on efficiency and safety of domestic tirofiban combined with thrombus aspiration for interventional therapy in Chinese patients with acute ST-segment elevation myocardial infarction

Objective To evaluate the efficacy and safety of domestic tirofiban combined with thrombus aspiration for inter- ventional therapy in Chinese patients with acute ST-segment elevation myocardial infarction. Methods The Cochrane Central Register of Controlled Trials, Pubmed, EMBASE, CKNI, Wanfang, and VIP were searched by computers to collect the randomized controlled trials. Two reviewers independently evaluated the quality of the included studies and extracted the data. Meta-an- alyses were performed using RevMan 5.0 software. Results Six randomized controlled trials （ RCTs ） involving 649 patients were included. The results of meta-analyses showed that domestic tirofiban combined with thrombus aspiration was superior to control in incidence of no flow （ OR - 0. 23, 95% CI： 0. 12 - 0. 24,P 〈 0. 01 ） and major adverse cardiac event （ OR = 0. 37, 95 % CI： 0. 19 -0. 75,P = 0. 005 ）. Conclusion Evidence shows that domestic tirofiban combined with thrombus aspiration for interventional therapy in Chinese patients with acute ST-segment elevation myocardial infarction has significant treatment effect, and the incidence of adverse reactions is low.