Abstract: 【Abstract】〓Objective〓By retrieving the articles published in Chinese, the Percutaneous Coronary Intervention (PCI) and Coronary Artery Bypass Grafting (CABG) were selected and compared between them, in whom all cases wene flowed up for more tham 24 months..The benefits and the risks of the cardiac revascularization via two different approaches were evaluated..The conclusion could be used as an evidence-based medicine base in the treatment of coronary heart disease..Methods〓The inclusion criteria, the exclusion criteria and the search strategy were made. The articles in the database of VIP Chinese Scientific & Technical Full Text Retrieval Database,.Wanfang Medical Database, CNKI and CBM were retrieved..The cohort study papers on the comparison of the cardiac revascularization via two different approaches were exacted. The quality of the papers was evaluated, and then the valid data was processed to the Meta analysis by RevMan 5.2 software..Results〓A total 33 papers were included in to the study literature with a total of 11,375 reported cases..In which,.the PCI group accounted for 6,125 cases,.while the CABG group accounted for 5,250 cases..The Meta-analysis reveals:.on the subject of the perioperative mortality,.the PCI group was significantly lower than the CABG group (1.22%, 4.12%), the OR value and the 95% CI was 0.29 (0.19-0.46), P<0.001. However the all-cause mortality during the whole follow-up period, there was no significant difference between the two groups (3.92%, 4.57%), the OR value and the 95% CI, 0.91 (0.7-1.10), P=0.33. On the revascularization rate, the PCI group was significantly higher than the CABG group (9.99%, 3.77%), the OR value and the 95% CI was 3.57 (2.62-4.87), P<0.001. On the incident of MACCE, the PCI group was significantly higher than the CABG group (17.94%, 12.35%), the OR value and the 95% CI is 1.62 (1.33-1.98), P<0.001. Conclusion〓The comparison of two methods of myocardial revascularization indicates that the PCI has the advantage in the aspects of the shorter perioperative period and the lower incidence of adverse events; however, the advantages of CABG is a better long-term prognosis and a lower incident of re-vascularization. During the decision making of the treatment of the coronary artery disease, the doctors should pay more attention to the disadvantages of each method, to choose the treatment plan with the long-term perspective.

Key words: CABG, Revascularization, Meta analysis, Coronary Artery Heart Disease, Percutaneous Coronary Intervention

摘要： 【摘要】 目的 检索国内关于PCI和CABG比较的文献,总结随访时间大于24个月病例的随访结果,评价两种心肌血运重建方式的益损,为临床上冠心病治疗决策的制定提供循证医学依据。方法〓制定原始文献的纳入标准、排除标准及检索策略,检索维普中文科技期刊全文数据库、万方医学数据库、中国知网和中国生物医学文献数据库(CBM),提取有关国内两种心肌血运重建方式比较的队列研究文献,评价纳入研究的文献质量,并提取有效数据后采用RevMan 5.2软件进行Meta分析。结果〓纳入研究的共33篇文献,共报道11375例,其中PCI组6125例,CABG组5250例。Meta分析结果显示:围手术期死亡率,PCI组明显低于CABG组(1.22%,4.12%),OR值及其95% CI为0.29(0.19~0.46),P<0.001;随访期全因死亡率,两组差别不明显(3.92%,4.57%),OR值及其95% CI为0.91(0.75~1.10),P=0.33;再次血运重建率,PCI组明显高于CABG组(9.99%,3.77%),OR值及其95% CI为3.57(2.62~4.87),P<0.001;MACCE发生率,PCI组明显高于CABG组(17.94%,12.35%),OR值及其95% CI为1.62(1.33~1.98),P<0.001。结论〓两种心肌的血运重建方式比较,PCI以其围手术期短且不良事件发生率低见长;而CABG的优点是远期效果好,再次血运重建率低,但在做出冠心病治疗决策时,要更多地关注到每种方法的不足,着眼长远。

关键词: 经皮冠状动脉介入术, 冠心病, Meta分析, 心肌血运重建, 冠状动脉搭桥术