中华临床医师杂志(电子版)
中華臨床醫師雜誌(電子版)
중화림상의사잡지(전자판)
CHINESE JOURNAL OF CLINICIANS(ELECTRONIC VERSION)
2013年
21期
9649-9655
,共7页
心力衰竭%心律失常,心性%胺碘酮%美托洛尔%Meta分析
心力衰竭%心律失常,心性%胺碘酮%美託洛爾%Meta分析
심력쇠갈%심률실상,심성%알전동%미탁락이%Meta분석
Heart failure%Arrhythmias,cardiac%Amiodarone%Metoprolol%Meta-analysis
目的:评价胺碘酮联合美托洛尔治疗慢性心力衰竭合并室性心律失常的疗效和安全性。方法计算机检索PubMed、中国生物医学文献数据库(网络版)、中国期刊全文数据库、万方数据库、重庆维普中文科技期刊全文数据库中有关美托洛尔和胺碘酮治疗慢性心力衰竭并室性心律失常疗效的随机对照试验(RCT),检索时限为建库至2013年10月。客观评价文献质量后,采用Revman 5.1软件对纳入的试验结果进行Meta分析。结果共纳入10篇RCT文献。Meta分析结果显示:心律失常总有效率(OR=4.01,95%CI:2.49~6.47,P<0.00001),心功能总有效率(OR=3.96,95%CI:2.56~6.12,P<0.00001),治疗前后左心室射血分数变化(WMD=7.70,95%CI:5.25~10.14,P<0.00001),心脏不良事件发生率(OR=0.13,95%CI:0.05~0.37,P=0.0001),再住院发生率(OR=0.26,95%CI:0.15~0.44,P<0.00001)五项指标比较,两组差异均有统计学意义。不良反应发生率(OR=1.55,95%CI:0.89~2.70,P=0.13)两组差异无统计学意义。结论胺碘酮联合美托洛尔治疗慢性心力衰竭并室性心律失常的疗效优于单用胺碘酮,不增加药物不良反应发生率,且降低心脏不良事件和再住院发生率。因纳入研究较少,样本量小,且质量不高,故仍需开展大样本、多中心、高质量的随机对照试验加以验证。
目的:評價胺碘酮聯閤美託洛爾治療慢性心力衰竭閤併室性心律失常的療效和安全性。方法計算機檢索PubMed、中國生物醫學文獻數據庫(網絡版)、中國期刊全文數據庫、萬方數據庫、重慶維普中文科技期刊全文數據庫中有關美託洛爾和胺碘酮治療慢性心力衰竭併室性心律失常療效的隨機對照試驗(RCT),檢索時限為建庫至2013年10月。客觀評價文獻質量後,採用Revman 5.1軟件對納入的試驗結果進行Meta分析。結果共納入10篇RCT文獻。Meta分析結果顯示:心律失常總有效率(OR=4.01,95%CI:2.49~6.47,P<0.00001),心功能總有效率(OR=3.96,95%CI:2.56~6.12,P<0.00001),治療前後左心室射血分數變化(WMD=7.70,95%CI:5.25~10.14,P<0.00001),心髒不良事件髮生率(OR=0.13,95%CI:0.05~0.37,P=0.0001),再住院髮生率(OR=0.26,95%CI:0.15~0.44,P<0.00001)五項指標比較,兩組差異均有統計學意義。不良反應髮生率(OR=1.55,95%CI:0.89~2.70,P=0.13)兩組差異無統計學意義。結論胺碘酮聯閤美託洛爾治療慢性心力衰竭併室性心律失常的療效優于單用胺碘酮,不增加藥物不良反應髮生率,且降低心髒不良事件和再住院髮生率。因納入研究較少,樣本量小,且質量不高,故仍需開展大樣本、多中心、高質量的隨機對照試驗加以驗證。
목적:평개알전동연합미탁락이치료만성심력쇠갈합병실성심률실상적료효화안전성。방법계산궤검색PubMed、중국생물의학문헌수거고(망락판)、중국기간전문수거고、만방수거고、중경유보중문과기기간전문수거고중유관미탁락이화알전동치료만성심력쇠갈병실성심률실상료효적수궤대조시험(RCT),검색시한위건고지2013년10월。객관평개문헌질량후,채용Revman 5.1연건대납입적시험결과진행Meta분석。결과공납입10편RCT문헌。Meta분석결과현시:심률실상총유효솔(OR=4.01,95%CI:2.49~6.47,P<0.00001),심공능총유효솔(OR=3.96,95%CI:2.56~6.12,P<0.00001),치료전후좌심실사혈분수변화(WMD=7.70,95%CI:5.25~10.14,P<0.00001),심장불량사건발생솔(OR=0.13,95%CI:0.05~0.37,P=0.0001),재주원발생솔(OR=0.26,95%CI:0.15~0.44,P<0.00001)오항지표비교,량조차이균유통계학의의。불량반응발생솔(OR=1.55,95%CI:0.89~2.70,P=0.13)량조차이무통계학의의。결론알전동연합미탁락이치료만성심력쇠갈병실성심률실상적료효우우단용알전동,불증가약물불량반응발생솔,차강저심장불량사건화재주원발생솔。인납입연구교소,양본량소,차질량불고,고잉수개전대양본、다중심、고질량적수궤대조시험가이험증。
ObjectiveTo evaluate the efficacy and safety of amiodarone and metoprolol in the treatment of chronic congestive heart failure with ventricular arrhythmias.MethodsThe databases of PubMed, CBM, CNKI, Wanfang and VIP were retrieved for collecting the randomized controlled trials (RCT) about amiodarone combined with metoprolol in treating chronic congestive heart failure with ventricular arrhythmias from the date of establishment of the databases to October 2013. After the critical evaluation on the quality of literature. The extracted data was analyzed by RevMen 5.1 software.ResultsA total 10 RCTs were discovered. Meta-analysis showed that there were statistical difference between two groups in evaluating the total effective rate of arrhythmias efficacy(OR=4.01, 95%CI: 2.49-6.47,P<0.000 01); the total effective rate of heart function efficacy (OR=3.96, 95%CI: 2.56-6.12,P<0.000 01);the changes of LEVF after treatment(WMD=7.70, 95%CI: 5.25-10.14,P<0.000 01); the incidence of adverse cardiac events(OR=0.13, 95%CI: 0.05-0.37,P=0.0001); the incidence of rehospitalization(OR=0.26, 95%CI: 0.15-0.44,P<0.000 01); there was no statistical difference between two groups in the incidence of side effects(OR=1.55, 95%CI: 0.89-2.70,P=0.13). ConclusionAmiodarone combined with metoprolol may be more effective than Amiodarone alone in the treatment of chronic congestive heart failure with ventricular arrhythmias without increase the side effects, and decrease the incidence of adverse cardiac events and rehospitalization. Due to the limitation of the included studies, more large-sample, multiple-center and high-quality RCTs are required.