• 中国科学论文统计源期刊
  • 中国科技核心期刊
  • 美国化学文摘(CA)来源期刊
  • 日本科学技术振兴机构数据库(JST)
临床输血与检验

临床输血与检验 ›› 2024, Vol. 26 ›› Issue (1): 72-78.DOI: 10.3969/j.issn.1671-2587.2024.01.012

• 临床输血 • 上一篇    下一篇

限制性输血与开放性输血对急性心肌梗死患者预后影响的Meta分析*

宋伟1, 王慧1, 卢静1, 肖华1, 吴耀华2, 郝泉水2   

  1. 1黄冈市中心医院输血科;
    2黄冈市中心医院麻醉科,湖北黄冈 438000
  • 收稿日期:2023-10-18 发布日期:2024-03-13
  • 通讯作者: 郝泉水,主要从事麻醉与危重病医学方面研究,（E-mail）haoquanshui@163.com。
  • 作者简介:宋伟,主要从事输血治疗学方面研究,（E-mail）songyuxinxiyue@126.com。
  • 基金资助:
    *本课题受湖北省卫生健康科研基金项目（No.WJ2021M084）资助

Meta-Analysis on Effect of Restrictive Blood Transfusion Versus Liberal Blood Transfusion Strategy in Patients with Acute Myocardial Infarction

SONG Wei1, WANG Hui1, LU Jing1, XIAO Hua1, WU Yaohua2, HAO Quanshui2   

  1. 1Department of Blood Transfusion;
    2Department of Anesthesiology, Huanggang Central Hospital, Huanggang, Hube 438000
  • Received:2023-10-18 Published:2024-03-13

RichHTML

4

PDF

211

摘要： 目的 采用Meta分析评价限制性输血与开放性输血策略对急性心肌梗死患者预后的影响。方法 计算机检索PubMed、Embase 、Web of Science、中国生物医学文献服务系统（SinoMed）、维普（VIP）、中国知网（CNKI）及万方数据知识服务平台（wanfang Data）中有关急性心肌梗死患者接受输血治疗的随机对照试验（RCT）,检索时间均从建库至2022年12月。由2名研究者按照纳入排除标准筛选文献、提取资料,2名评价员独立对纳入文献的质量进行评价,采用RevMan5.3进行Meta分析,比较限制性输血与开放性输血策略对急性心肌梗死患者住院期间全因病亡率,总死亡率,随访再梗塞、非计划血管重建、心力衰竭及卒中发生等心血管不良事件的影响差异。结果 最终纳入6项研究共3311例患者。Meta 分析结果显示,限制性输血与开放性输血策略在院内死亡风险相对危险度（RR）RR=0.68,95%CI为0.31~1.48,P=0.33、总体死亡率（RR=0.83,95%CI为0.47~1.49,P=0.54）、随访再梗塞（RR=1.59,95%CI为0.38~6.75,P=0.53）、非计划血管重建（RR=0.83,95%CI为0.39~1.73,P=0.61）、心力衰竭（RR=0.74,95%CI为0.16~3.46,P=0.70）、卒中发生（RR=0.69,95%CI为0.14~3.48,P=0.65）等差异均无统计学意义。结论 限制性输血与开放性输血比较,老年AMI患者住院期间全因病亡率,总死亡率,随访再梗塞、非计划血管重建、心力衰竭及卒中发生等心血管不良事件的发生率未见明显差异,由于纳入研究异质性较高,需更多RCT进一步证实,临床应谨慎对待本研究的结论。

关键词: 输血, 心肌梗死, 病死率, Meta分析

Abstract: Objective To evaluate the effect of restrictive blood transfusion versus liberal blood transfusion strategy in patients with Acute Myocardial Infarction using meta-analysis. Methods American Medical Library (PubMed), Holland Medical Abstract (Embase), Web of Science, SinMed, Weipu database, China National Knowledge Infrastructure (CNKI) and Wanfang databases were searched from their start year up to Dec. 2022 for relevant randomized clinical trials (RCT) that compared restrictive blood transfusion to liberal blood transfusion in patients with Acute Myocardial Infarction. RCTs that met the inclusion criteria were screened and included, and meta-analysis was conducted using the RevMan5.3 software. The outcomes of in-hospital mortality, overall mortality, follow-up reinfarction, major adverse cardiovascular events (MACE) were evaluated. Results Six studies involving 3311 patients were included in this meta-analysis. The results of meta-analysis showed no significant difference between the two groups regarding the In-hospital mortality(RR(risk ratio)=0.68,95%CI：0.31~1.48,P=0.33),Overall mortality(RR=0.83,95%CI：0.47~1.49,P=0.54),Follow-up reinfarction(RR=1.59,95%CI：0.38~6.75,P=0.53),Unplanned revascularization(RR=0.83,95%CI：0.39~1.73,P=0.61),Heart Failure,(RR=0.74,95%CI：0.16~3.46,P=0.70)and Stroke(RR=0.69,95%CI：0.14~3.48,P=0.65). Conclusions No significant differences were seen in the In-hospital mortality,overall mortality,and the incidence of adverse cardiovascular events such as follow-up reinfarction,unplanned revascularization,heart failure and stroke occurrence in elderly patients with AMI when open transfusion was compared with restrictive transfusion.

Key words: Blood transfusion, Acute Myocardial infarction, Mortality, Meta-analysis

中图分类号: