冠状动脉旁路移植术前应用瑞舒伐他汀预防术后早期房颤效果的Meta分析

摘要

Objective To systematically review the efficacy of the prevention of postoperative early onset atrial fibril-lation by earlier application of rosuvastatin in coronary artery bypass grafting(CABG).Methods Articles about relevant randomized controlled trials ( RCTs) were electronically searched from BMA, EMbase, ASP, the cochrane library, EMCC, Pubmed, CBM, CNKI, CECDB, CQVIP, and VIP databases published during January 2004 to January 2014.The quality of the included studies was treated with strict appraisal and data extraction.Then, meta-analysis was performed by using Stata/SE version 12 software to analysis all the articles.Results Eventually, 7 articles of RCT were included involving 1 479 cases of patients, of which, 790 cases were treated with rosuvastatin 10 or 20 mg before CABG operation( treatment group) , 689 cases were treated with placebo before operation( control group) .The results of meta analysis demonstrate that compared with control group, early postoperative morbidity of atrial fibrillation reduced in treatment group in both 10 and 20 mg dose rosuvastatin [RR was 0.70 and 0.65, respectivly;95%CI was (0.55, 0.90) and (0.51, 0.83), respectively;P was 0.407 and 0.770, respectively].Conclusions Earlier application of rosuvastatin before CABG can effectively re-duce the probability of postoperative early onset atrial fibrillation.%目的：系统评价冠状动脉旁路移植术（ CABG）前应用瑞舒伐他汀预防术后早期房颤的效果。方法检索2004年1月～2014年1月英国医学会电子全文期刊数据库（ BMA）、荷兰医学文摘数据库（ EMbase）、学术期刊集成全文数据库（ ASP）、考克兰图书馆（ The Cochrane Library）、西文生物医学期刊文献数据库（ EMCC）、美国国立医学图书馆生物医学信息检索系统（Pubmed）、万方数据库（CECDB）、维普中文科技期刊全文数据库（CQVIP）、中文科技期刊数据库（VIP）、中国生物医学文献数据库（CBM）、中国学术期刊全文数据库（CNKI）等数据库内CABG相关的随机对照试验，对纳入文献进行质量评价，采用Stata／SE version 12．0软件对纳入研究进行Meta分析。结果最终纳入文献7篇，共1479例患者，其中治疗组790例，CABG前服用瑞舒伐他汀10 mg或20 mg；对照组689例，术前服用安慰剂。 Meta分析结果显示，治疗组术后早期房颤发生率均低于对照组（ RR分别为0．70、0．65，95％CI分别为0．55～0．90、0．51～0．83，P值分别为0．407、0．770）。结论冠状动脉旁路移植术前应用瑞舒伐他汀能有效降低术后早期房颤的发生率。