目的 系統(tǒng)評價(jià)半劑量替羅非班用于中國急性心肌梗死患者經(jīng)皮冠狀動(dòng)脈內(nèi)支架置入術(shù)（PCI）術(shù)后的療效和安全性，為臨床提供循證醫(yī)學(xué)證據(jù)。方法 檢索中國學(xué)術(shù)期刊全文數(shù)據(jù)庫（CNKI）、中國生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫（CBM）、維普中文期刊全文數(shù)據(jù)庫（VIP）、萬方數(shù)據(jù)庫、Cochrane圖書館、PubMed和EMBase數(shù)據(jù)庫，均從建庫至2019年5月，收集中國急性心肌梗塞患者PCI術(shù)后使用半劑量（觀察組）對比標(biāo)準(zhǔn)劑量（對照組）替羅非班的臨床隨機(jī)對照研究（RCT），提取資料和質(zhì)量評價(jià)后，采用RevMan 5.3軟件進(jìn)行Meta-分析。結(jié)果 共納入16個(gè)RCTs，包括1 702例患者。Meta-分析結(jié)果顯示：觀察組患者PCI術(shù)后左心室射血分?jǐn)?shù)（MD=-1.20，95%CI=-2.52～0.13）、心肌梗死溶栓后血流分級3級構(gòu)成比（OR=0.74，95%CI=0.54～1.03）、心電圖ST段抬高回落率（OR=0.78，95%CI=0.53～1.15）、主要心血管不良事件發(fā)生率（OR=1.16，95%CI=0.86～1.56）與對照組比較均無顯著性差異，但出血及并發(fā)癥發(fā)生率（OR=0.36，95%CI=0.27～0.49）顯著小于對照組（P<0.01）。結(jié)論 中國急性心肌梗死患者PCI術(shù)后予以半劑量替羅非班的臨床療效與標(biāo)準(zhǔn)劑量相當(dāng)，但安全性優(yōu)于標(biāo)準(zhǔn)劑量。

Objective To systematically evaluate the efficacy and safety of half-dose tirofiban for patients with acute coronary syndrome (ACS) after percutaneous coronary intervention (PCI) in China. And provide evidence-based medical evidence for clinical practice. Methods A randomized controlled trial (RCT) of half-dose (observation group) vs standard dose (control group) of tirofiban for patients with acute coronary syndrome after PCI in Chinese were conducted in CNKI, Wanfang, WIP, CBM, Cochrane Library, PubMed and EMBase from the database to May 2019. Date were extracted and evaluated by two reviewers independently with designed extraction form. The RevMan 5.3 software was used to carry out statistic analysis. Result A total of 16 RCTs and 1 702 patients were included. Meta-analysis results showed: there were no significant differences in the LVEF% (MD = - 1.20, 95%CI= -2.52 ~ 0.13), rate of TIMI blood flow grading grade 3 (OR = 0.74, 95%CI = 0.54 ~ 1.03), ST segment elevation fallback (OR=0.78, 95%CI= 0.53 ~ 1.15) and MACE (OR = 1.16, 95%CI = 0.86 ~ 1.56) between the observation group and the control group. However, the rate of bleeding and complications (OR= 0.36, 95% CI=0.27 ~ 0.49) of was the observation group significantly lower than that of the control group (P < 0.01). Conclusion The clinical efficacy of half-dose tirofiban after PCI in patients with ACS in China is comparable to the standard dose, but its safety is better than the standard dose.

R944.5