Objective To investigate the effect of oxygen therapy and indoor air or titration oxygen on patients with acute myocardial infarction ( AMI) . Methods Through PubMed, Web of Knowledge, Embase, The Cochrane Library ( February 2018), CNKI, VIP, CBM, Wanfang database in Chinese or English, we searched for randomized controlled trials on oxygen therapy for AMI patients. According to the standard, two evaluators independently screened the documents, extracted the data, evaluated the quality of the documents, and used revman5. 3 software to analyze the data. Results A total of 8 149 patients with AMI were included in 9 articles. Combined data showed that oxygen therapy did not reduce the risk of short-term all-cause death ( RR =1. 09, 95% CI: 0. 82-1. 45, P =0. 57), arrhythmia ( RR =0. 98, 95% CI:0. 85-1. 14, P=0. 79), major cardiovascular events (RR=1. 00, 95% CI: 0. 52-1. 92, P=1. 00), cardiac shock (RR=0. 90, 95% CI: 0. 63-1. 30, P=0. 58), heart failure (RR=0. 95, 95% CI: 0. 65-1. 40, P=0. 80) and pain (RR=1. 05, 95% CI: 0. 89-1. 23, P=0. 08) in patients with AMI. On the contrary, the number of recurrent cases of myocardial ischemia or myocardial infarction (RR=1. 56, 95% CI: 1. 10-2. 22, P=0. 01) was increased. Conclusions This meta analysis suggests that oxygen therapy could not benefit AMI patients with normal oxygen saturation; but may have adverse effects. Individualized oxygen treatment should be used in AMI patients according to whether they are hypoxic or not.%目的 探讨氧疗与呼吸室内空气或滴定氧在急性心肌梗死( AMI)患者中的作用效果.方法 通过检索PubMed、Web of Knowledge、Embase、The Cochrane Library(2018年2月)、中国知网资源总库、维普中文科技期刊数据库、中国生物医学文献数据库、万方数据库等,查找关于AMI患者氧疗的随机对照试验(RCT).由两名评价人员按照标准独立筛选文献、提取资料、评价文献质量,应用RevMan5. 3分析软件对资料进行荟萃分析. 结果 共纳入9篇文献,8 149例AMI患者.数据合并结果显示,氧疗并未降低AMI患者短期全因死亡的风险( RR=1. 09,95% CI:0. 82～1. 45,P=0. 57)、心律失常(RR=0. 98,95% CI:0. 85 ～1. 14,P=0. 79)、主要心血管事件( RR=1. 00,95% CI:0. 52 ～1. 92,P=1. 00)、心原性休克( RR =0. 90,95% CI:0. 63 ～1. 30, P =0. 58)、心力衰竭( RR =0. 95, 95% CI:0. 65～1. 40,P=0. 80)和疼痛(RR=1. 05,95% CI:0. 89～1. 23,P=0. 08)等结局指标的发生,但增加了心肌缺血或心肌梗死的再发例数( RR=1. 56,95% CI:1. 10～2. 22,P=0. 01). 结论 氧疗并不能使氧饱和度正常的AMI患者明显获益,反而会产生不良影响;对于AMI患者是否用氧,应根据其是否缺氧进行个体化治疗.
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