急性心肌梗塞的死亡率和医院前血栓溶解:一个元分析
L J Morrison1, P R Verbeek, A C McDonald
1Sunnybrook and Women's College Health Science Centre, 2075 Bayview Ave, Suite BG-20, Toronto, Ontario, Canada M4N 3M5. l.morrison@utoronto.ca
JAMA
|May 20, 2000
概括
针对急性心肌梗塞 (AMI) 的医院前血栓溶解显著降低了死亡率和治疗时间. 这一元分析证实了与医院内管理相比,它的有效性.
科学领域:
- 心脏病学 心脏病学
- 紧急医疗 紧急医疗
- 临床试验 临床试验
背景情况:
- 针对急性心肌梗塞 (AMI) 的早期血栓溶解可以改善存活率.
- 没有关于医院前与医院内血栓溶解的全面系统审查.
研究的目的:
- 进行随机对照试验的元分析,比较AMI的医院前和医院内血栓溶解.
- 评估对住院死亡率的影响.
主要方法:
- 在多个数据库 (MEDLINE,EMBASE等) 进行了搜索. 和相关随机对照试验 (RCT) 的其他来源.
- 包括6个RCT (6434名患者),比较AMI的医院前与医院内血栓溶解.
- 盲目审稿人的独立数据抽象和质量评估.
主要成果:
- 医院前血栓溶解显著降低了所有原因的医院死亡率 (OR,0.83;95% CI,0.70-0.98).
- 在临床组中,血栓溶解的时间显著缩短 (104分 vs 162分).
- 在不同的试验质量和提供者经验水平上,结果一致.
结论:
- 针对AMI的医院前血栓溶解与治疗时间的缩短以及较低的全因医院死亡率有关.
- 这种方法为急性心肌梗塞患者提供了显著的生存益处.
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