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目的系统评价西莫罗斯洗脱支架(SES)与裸支架(BMS)比较治疗ST段升高的急性心肌梗死的有效性和安全性。方法计算机检索PubMed(1960～2011.3)、EMbase(1980～2011.3)、Cochrane图书馆(1989～2011.3)、CBM(1979～2011.3)、VIP(1989～2011.3)和CNKI(1979～2011.3),纳入西莫罗斯洗脱支架与裸支架比较治疗ST段升高的急性心肌梗死的随机对照试验(RCT)。对纳入研究进行资料提取和方法学质量评价后,采用RevMan 4.2软件进行Meta分析。结果共纳入7个RCT,2555例患者,其中SES组1282例,BMS组1273例,Jadad评分均≥3。Meta分析结果显示,SES组在靶病变血运重建率[OR=0.27,95%CI(0.16,0.45),P<0.00001]及靶血管血运重建率[OR=0.33,95%CI(0.24,0.46),P<0.00001]方面均优于BMS组,但在病死率、支架内血栓形成率以及心肌梗死再发生率方面,两组差异无统计学意义。结论从1年期的临床结果来看,相比裸支架而言,西罗莫司洗脱支架可以有效降低靶病变血运重建率和靶血管血运重建率。
Objective To systematically evaluate the efficacy and safety of Simmons’ s eluting stent (SES) and bare stent (BMS) in the treatment of acute myocardial infarction with elevated ST segment. Methods PubMed (1960 ~ 2011.3), EMbase (1980 ~ 2011.3), Cochrane Library (1989 ~ 2011.3), CBM (1979 ~ 2011.3), VIP (1989 ~ 2011.3) and CNKI A Randomized Controlled Trials (RCT) Comparison of Rose Stent and Bare Stent in the Treatment of Acute Myocardial Infarction with Elevated ST Segment. Meta-analysis was performed using RevMan 4.2 software after data extraction and methodological quality evaluation were included in the study. Results A total of 7 RCTs were enrolled in 2555 patients. Among them, 1282 were in SES group, 1273 in BMS group, and Jadad score was ≥3. The results of Meta analysis showed that the rate of target vessel revascularization [OR = 0.27, 95% CI (0.16,0.45), P <0.00001] and target vessel revascularization [OR = 0.33,95% CI 0.46), P <0.00001], but there was no significant difference between the two groups in the case fatality rate, the rate of stent thrombosis and the rate of recurrent myocardial infarction. CONCLUSIONS: From a one-year clinical trial, sirolimus-eluting stents can effectively reduce the target revascularization rate and target revascularization rate compared with bare-metal stents.