临床误诊误治
臨床誤診誤治
림상오진오치
CLINICAL MISDIAGNOSIS & MISTHERAPY
2014年
11期
109-113
,共5页
张尧%唐其柱%李芳芳%张宁%周梦桥
張堯%唐其柱%李芳芳%張寧%週夢橋
장요%당기주%리방방%장저%주몽교
ω-3多不饱和脂肪酸%心力衰竭%meta分析
ω-3多不飽和脂肪痠%心力衰竭%meta分析
ω-3다불포화지방산%심력쇠갈%meta분석
Fatty acids,omega-3%Heart failure%Meta-analysis
目的：评价ω-3多不饱和脂肪酸治疗慢性心力衰竭( chronic heart failure, CHF)的效果。方法检索1990—2014年中国期刊全文数据库、中国生物医学文献数据库、维普中文科技期刊、万方医学数据库、PubMed、Co-chrane 图书馆及Embase中收录的关于ω-3多不饱和脂肪酸治疗CHF效果的随机对照试验,严格资料提取并评价文献质量,对符合标准的文献使用Rev Man 5.1软件进行meta分析。结果最终纳入文献4篇7149例,其中试验组3583例,观察组3566例。文献质量评价结果B级3篇,A级1篇。3篇文献统计了左心室射血分数( LVEF)和心脏脑钠肽( BNP)水平,2篇文献统计了肿瘤坏死因子-α( TNF-α)水平和全因病死率。 meta分析结果显示治疗终点时试验组LVEF高于对照组,心脏BNP和TNF-α水平低于对照组,差异均有统计学意义[(MD =0.85,95%可信区间(95%CI)0.10~1.61,P=0．03；MD =-169.20,95%CI -208.77~129.63,P<0．00001；MD=0.32,95%CI 0.20~0.43, P<0．00001)]；随访期间试验组及对照组全因病死率比较差异无统计学意义(OR=0.91,95%CI 0.81~1.02,P=0．10)。结论ω-3多不饱和脂肪酸治疗CHF,能改善患者心功能及血管炎症状况,但不能够降低患者全因病死率。
目的：評價ω-3多不飽和脂肪痠治療慢性心力衰竭( chronic heart failure, CHF)的效果。方法檢索1990—2014年中國期刊全文數據庫、中國生物醫學文獻數據庫、維普中文科技期刊、萬方醫學數據庫、PubMed、Co-chrane 圖書館及Embase中收錄的關于ω-3多不飽和脂肪痠治療CHF效果的隨機對照試驗,嚴格資料提取併評價文獻質量,對符閤標準的文獻使用Rev Man 5.1軟件進行meta分析。結果最終納入文獻4篇7149例,其中試驗組3583例,觀察組3566例。文獻質量評價結果B級3篇,A級1篇。3篇文獻統計瞭左心室射血分數( LVEF)和心髒腦鈉肽( BNP)水平,2篇文獻統計瞭腫瘤壞死因子-α( TNF-α)水平和全因病死率。 meta分析結果顯示治療終點時試驗組LVEF高于對照組,心髒BNP和TNF-α水平低于對照組,差異均有統計學意義[(MD =0.85,95%可信區間(95%CI)0.10~1.61,P=0．03；MD =-169.20,95%CI -208.77~129.63,P<0．00001；MD=0.32,95%CI 0.20~0.43, P<0．00001)]；隨訪期間試驗組及對照組全因病死率比較差異無統計學意義(OR=0.91,95%CI 0.81~1.02,P=0．10)。結論ω-3多不飽和脂肪痠治療CHF,能改善患者心功能及血管炎癥狀況,但不能夠降低患者全因病死率。
목적：평개ω-3다불포화지방산치료만성심력쇠갈( chronic heart failure, CHF)적효과。방법검색1990—2014년중국기간전문수거고、중국생물의학문헌수거고、유보중문과기기간、만방의학수거고、PubMed、Co-chrane 도서관급Embase중수록적관우ω-3다불포화지방산치료CHF효과적수궤대조시험,엄격자료제취병평개문헌질량,대부합표준적문헌사용Rev Man 5.1연건진행meta분석。결과최종납입문헌4편7149례,기중시험조3583례,관찰조3566례。문헌질량평개결과B급3편,A급1편。3편문헌통계료좌심실사혈분수( LVEF)화심장뇌납태( BNP)수평,2편문헌통계료종류배사인자-α( TNF-α)수평화전인병사솔。 meta분석결과현시치료종점시시험조LVEF고우대조조,심장BNP화TNF-α수평저우대조조,차이균유통계학의의[(MD =0.85,95%가신구간(95%CI)0.10~1.61,P=0．03；MD =-169.20,95%CI -208.77~129.63,P<0．00001；MD=0.32,95%CI 0.20~0.43, P<0．00001)]；수방기간시험조급대조조전인병사솔비교차이무통계학의의(OR=0.91,95%CI 0.81~1.02,P=0．10)。결론ω-3다불포화지방산치료CHF,능개선환자심공능급혈관염증상황,단불능구강저환자전인병사솔。
Objective To review the effectiveness of omega-3 polyunsaturated fatty acids in the treatment of chronic heart failure. Methods The documents of randomized controlled trials ( RCT) related to the treatment of chronic heart failure withω-3 polyunsaturated fatty acids published during 1990 and 2014 were retrieved from the databases of CNKI, CBM, VIP, PubMed, Cochrane and Embase. The documents were screened, extracted and evaluated according to inclusion and exclusion criteria, and a meta-analysis was performed by using RevMan 5. 1 software. Results In total there were 4 RCT (7149 pa-tients) , in which 3583 cases were in test group, and 3566 cases were in the observation group. Through the quality assessment of literature, there were three articles of class B and one article of class A. 3 papers reported left ventricular ejection fraction ( LVEF) and brain natriuretic peptide ( BNP) , and 2 papers reported tumor necrosis factor-alpha ( TNF-α) and all-cause mor-tality rate. The results of meta-analysis showed as follows: the differences of LVEF, BNP and TNF-α between the two groups were significant (MD=0. 85, 95%CI:0. 10-1. 61, P=0. 03;MD= -169. 20, 95%CI:-208. 77-129. 63, P<0. 00001;MD=0. 32, 95%CI:0. 20-0. 43, P<0. 00001). While its influences on all-cause mortality rate showed no statistical difference be-tween the two groups (OR=0. 91, 95%CI:0. 81-1. 02, P=0. 10). Conclusion Omega-3 polyunsaturated fatty acids can sig-nificantly improve heart function and vascular inflammatory status in the patients with chronic heart failure, but not reduce the all-cause mortality of patients.
