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应用SGLT-2抑制剂在急性心肌梗死经皮冠状动脉介入术后患者的有效性及安全性的Meta分析
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Abstract:
目的：评价钠–葡萄糖共转运蛋白2 (SGLT-2)抑制剂对急性心肌梗死PCI术后的有效性及安全性？方法：计算机搜索PubMed？Web of Science？Cochrane Library？Embase？中国知网、维普网、万方数据库，收集SGLT-2抑制剂对急性心肌梗死的影响的随机对照研究(randomized controlled trial, RCT)，检索时限均为建库起至2023年10月10日？由两名研究者独立筛选文献，提取资料并评价纳入研究的偏倚风险？依照纳入和排除标准进行文献筛选？数据提取以及质量评价，采用RevMan 5.3软件进行Meta分析？结果：共9篇文献纳入研究，共计1145例患者？Meta分析结果显示，与对照组相比，SGLT-2抑制剂治疗可降低急性心肌梗死患者PCI术后的主要不良心血管事件(MACE)发生率(RR = 0.52, 95% CI: 0.36~0.76, P = 0.0006)、心力衰竭发生率(RR = 0.45, 95% CI: 0.27~0.75, P = 0.002)，改善左室射血分数(MD = 1.69, 95% CI: 0.24~3.15, P = 0.02)，升高NT-proBNP (MD = ？77.70, 95% CI: ？147.57~？7.82, P = 0.03)，在不良事件发生(RR = 1.43, 95% CI: 0.94~2.18, P = 0.09)上差异无统计学意义？结论：SGLT-2抑制剂可降低急性心肌梗死PCI术后短期内不良事件(MACE)的发生，改善心功能，并且安全性较好？
Objective: To evaluate the efficacy and safety of sodium-glucose co-transporter 2 (SGLT-2) inhibitors in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI). Methods: PubMed, Web of Science, Cochrane Library, Embase, CNKI, VIP and Wanfang Database were searched for randomized controlled trials (RCTS) on the effect of SGLT-2 inhibitors on acute myocardial infarction trial, RCT, and the search time limit was from the establishment of the database to October 10, 2023. Two researchers independently screened the literature, extracted data, and evaluated the risk of bias of the included studies. Literature screening, data extraction and quality assessment were performed according to the inclusion and exclusion criteria. RevMan 5.3 software was used for Meta-analysis. Results: Nine studies involving 1145 patients were included. The results of meta-analysis showed that SGLT-2 inhibitors could reduce the incidence of major adverse cardiovascular events (MACE) (RR = 0.52, 95% CI: 0.36~0.76, P = 0.0006) and the incidence of heart failure (RR = 0.45, 95% CI: 0.27~0.75, P = 0.002), improvement of left ventricular ejection fraction (MD = 1.69, 95% CI: 0.24~3.15, P = 0.02), and increased NT-proBNP (MD = ？77.70, 95% CI: ？147.57~？7.82, P = 0.03). There was no significant difference in the incidence of adverse events (RR = 1.43, 95% CI: 0.94~2.18, P = 0.09). Conclusion: SGLT-2 inhibitors can reduce the incidence of short-term adverse events (MACE) in patients with acute myocardial infarction after PCI, improve cardiac function, and have good safety.
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