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|本期目录/Table of Contents|

室间隔消融术治疗肥厚型心肌病的Meta分析

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2014年第4期
页码:
446-450
栏目:
临床研究
出版日期:
2014-04-25

文章信息/Info

Title:
Comparison of septal ablation and myectomy in treatment of hypertrophic cardiomyopathy: A meta-analysis
作者:
吴青青; 唐其柱; 李芳芳; 徐 蔓; 袁 园; 卞洲艳
(武汉大学人民医院心内科，湖北 武汉 430060)
Author(s):
WU Qing-qing;  TANG Qi-zhu;  LI Fang-fang;  XU Man;  YUAN Yuan;  BIAN Zhou-yan
(Department of Cardiology, Renmin Hospital, Wuhan University, Wuhan 430060, Hubei, China)
关键词:
肥厚性心肌病; 射频消融; 室间隔部分切除术; 随机对照试验; Meta分析
Keywords:
hypertrophic cardiomyopathy;  septal ablation;  myectomy;  randomized controlled trials;  meta-analysis
分类号:
R542.2
DOI:
-
文献标识码:
A
摘要:
目的:评价分析消融术治疗肥厚型心肌病的疗效以及安全性。方法： 检索PubMed数据库、MedLine数据库、Embase数据库、Cochrane临床对照试验中心注册库和CNKI全文数据库、万方全文数据库、维普全文数据库自建库以来至2013公开发表的与室间隔消融术治疗肥厚型心肌病相关的文章，并加手工检索。限定文献发表类型为临床随机对照试验(RCT)。对资料进行筛选，选取针对性强的文章，排除重复研究。对筛选出的文献查找全文。采用RevMan5.0.25软件对纳入的试验结果进行meta分析。结果: 共纳入7篇RCT，共445名肥厚性心肌病患者， Meta分析结果表明：室间隔射频消融与室间隔部分切除术相比，其术后全因病死率（RD=0.00，95%CI：-0.03-0.04，P=0.88）、左室流出道压差的改变（4.50，95%CI：-1.08-10.07，P=0.11）均无明显差异，而且室性心律失常发生率、起搏器置入率（OR=1.67，95%CI：0.86-3.26，P=0.13）、二尖瓣关闭不全发生率两组之间无显著差异；而与室间隔部分切除术相比室间隔射频消融术对心功能改善的效果较差（0.31，95%CI：0.16-0.45，P<0.01）。结论： 室间隔射频消融术与室间隔部分切除术相比在治疗肥厚性心肌病的疗效及安全性无明显差异，仅在对肥厚性心肌病患者心功能改善的效果上较差。
Abstract:
AIM:To evaluate the efficacy and safety of septal ablation and myectomy in treatment of hypertrophic cardiomyopathy. METHODS: PubMed, MedLine, Cochrane library and China National Knowledge Infrastructure (CNKI) databases were searched for literature on clinical trials of septal ablation in treatment of hypertrophic cardiomyopathy in comparison with myectomy, using key words “hypertrophic cardiomyopathy,” “septal ablation” and “myectomy.” A manual search of those trials was simultaneously performed. A meta-analysis was conducted on the outcomes of the included trials with the assistance of RevMan 5.025 software. RESULTS: A total of seven randomized controlled trials (RCT) were discovered including 445 patients. No significant difference was found in the all-cause mortality (RD=0.00, 95%CI:-0.03 to 0.04, P=0.88) and reduction in left ventricular outflow tract gradient (4.50, 95%CI:-1.08 to 10.07, P=0.11) between septal myectomy group and septal ablation group. The post-procedure ventricular arrhythmia rate, pacemaker implantation rate (OR=1.67, 95%CI: 0.86 to 3.26, P=0.13) and mitral regurgitation rate revealed insignificant differences. But the post-procedure reduction in NYHA functional class in septal ablation group was lower compared with that in the septal myectomy group (0.31, 95% CI: 0.16 to 0.45, P<0.01). CONCLUSION: There is no significant difference in efficacy and safety between septal ablation and myectomy in treatment of hypertrophic cardiomyopathy. Septal ablation is less effective for improvement of cardiac functions.

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备注/Memo

备注/Memo:
收稿日期：2013-09-03.通讯作者：唐其柱，教授，主要从事心肌疾病的发展及防治研究 Email：qztang@whu.edu.cn 作者简介：吴青青，博士生 Email：qingwu20130@163.com
更新日期/Last Update: 2014-05-06