CAJ | 학술논문

目的：系统评价伊伐布雷定治疗稳定型心绞痛的有效性和安全性。方法在中国学术期刊全文数据库（CNKI）（1997～2014?．4）、万方数据库（1989～2014．4）、EMBASE（1974～2014．4）、PUBMED（1966～2014．4）数据库检索有关伊伐布雷定治疗稳定型心绞痛的随机对照试验文献，观察组应用伊伐布雷定治疗，对照组应用常规药物，以静息和运动时最大心率下降值、ST段压低1 mm阈值、运动时最高血压值和运动持续时间等5个方面的加权均数差（ WMD）为疗效指标，以2组发生不良反应的相对危险度（ RR）为安全性指标进行Meta分析。结果共纳入8项随机对照临床试验，包括4582例患者，其中观察组2439例，对照组2143例。分析结果显示，观察组静息心率下降值优于对照组（WMD＝4．83，95％CI 2．39～7．28， P ＝0．0001）；运动最大心率下降值优于对照组（WMD＝7．22，95％ CI 2．60～11．85， P ＝0．002）；ST段压低1 mm阈值优于对照组（WMD＝12．04，95％CI 2．84～21．25， P ＝0．01）；运动持续时间优于对照组（WMD＝31．80，95％CI 25．76～37．84， P ＜0．01）；运动时血压最高值与对照组无显著差异（Std-WMD＝0．02，95％ CI -0．52～0．56， P ＝0．93）；观察组不良反应发生率与对照组有显著差异（RR＝2．43，95％CI 1．33～4．45， P ＝0．004）。结论伊伐布雷定治疗稳定型心绞痛疗效好，且安全性好，值得临床应用。
목적：계통평개이벌포뢰정치료은정형심교통적유효성화안전성。방법재중국학술기간전문수거고（CNKI）（1997～2014?．4）、만방수거고（1989～2014．4）、EMBASE（1974～2014．4）、PUBMED（1966～2014．4）수거고검색유관이벌포뢰정치료은정형심교통적수궤대조시험문헌，관찰조응용이벌포뢰정치료，대조조응용상규약물，이정식화운동시최대심솔하강치、ST단압저1 mm역치、운동시최고혈압치화운동지속시간등5개방면적가권균수차（ WMD）위료효지표，이2조발생불량반응적상대위험도（ RR）위안전성지표진행Meta분석。결과공납입8항수궤대조림상시험，포괄4582례환자，기중관찰조2439례，대조조2143례。분석결과현시，관찰조정식심솔하강치우우대조조（WMD＝4．83，95％CI 2．39～7．28， P ＝0．0001）；운동최대심솔하강치우우대조조（WMD＝7．22，95％ CI 2．60～11．85， P ＝0．002）；ST단압저1 mm역치우우대조조（WMD＝12．04，95％CI 2．84～21．25， P ＝0．01）；운동지속시간우우대조조（WMD＝31．80，95％CI 25．76～37．84， P ＜0．01）；운동시혈압최고치여대조조무현저차이（Std-WMD＝0．02，95％ CI -0．52～0．56， P ＝0．93）；관찰조불량반응발생솔여대조조유현저차이（RR＝2．43，95％CI 1．33～4．45， P ＝0．004）。결론이벌포뢰정치료은정형심교통료효호，차안전성호，치득림상응용。
Objective System evaluation of ivabradine's effective and safty in treatment of stable angina pectoris . Methods From Chinese academic journal full text database (CNKI) (1997-2014.4), Wanfang database (1989-2014. 4), EMBASE (1974-2014.4), PUBMED (1966-2014.4) database retrieval of ivabradine randomized controlled trials on the treatment of stable angina pectoris , the observation group application of ivabradine therapy , the control group application of conventional drugs , with rest and maximum heart rate during exercise , the decreased value of ST segment depression in 1 mm threshold, the value and the movement exercise hypertension duration weighted 5 aspects of the weighted mean difference ( WMD) as indicators of efficacy , the relative risk ( RR) of adverse reactions in 2 groups as the safety index to perform the Meta-analysis.Results A total of 8 randomized controlled clinical trials were included , including 4 582 patients, including 2 439 cases in observation group , 2 143 cases in the control group .The results showed that , the observation group resting heart rate decrease obviously than that in the control group (WMD=4.83, 95% CI 2.39-7.28, P =0.000 1); motion maximum heart rate decrease obviously than that in the control group (WMD=7.22, 95% CI 2.60-11.85, P =0.002);ST segment depression in 1 mm threshold is better than that of the control group (WMD=12.04, 95%CI 2.84-21.25,P=0.01);exercise duration better than the control group (WMD=31.80, 95%CI 25.76-37.84, P <0.01);exercise blood pressure with the highest value of the control group had no significant difference (StdWMD=0.02,95% CI -0.52-0.56, P=0.93);there were no significant difference of adverse reaction between the observation group and the control group (RR=2.43, 95%CI 1.33-4.45, P =0.004).Conclusion Ivabradine in the treatment of stable angina pectoris is well , as well the safety, worthy of clinical application .