CAJ | 학술논문

目的：系统评价胺碘酮预防心脏外科术后心房颤动（房颤）有效性和安全性。方法计算机检索中国生物医学文献数据库（1978~2014.07）、中国期刊全文数据库（1994~2014.07）、维普数据库（1999~2014.07）、万方数据库（1990~2014.07）、PubMed（1990~2014.07）、Cochrane Library（2014第07期）。按纳入排除标准由两名研究者独立进行筛选，并提取资料，采用改良的JADAD量表评价纳入研究的质量后，采用RevMan 5.2软件进行Meta分析。结果共纳入18篇文献，均为随机对照研究，总共1964例患者。Meta分析结果显示：与安慰剂（对照组）相比，胺碘酮（试验组）降低心脏外科术后房颤发生率（RR=1.46，95%CI：1.36~1.57，P＜0.00001），而安全性无统计学差异（RR=1.16，95%CI：0.89~1.50，P=0.27）。亚组分析显示，胺碘酮不同给药方式和不同首次给药时间均对心脏外科术后房颤有效性无明显影响，与总有效性一致。结论与安慰剂相比，胺碘酮可以有效地降低心脏外科术后房颤的发生率，安全性无明显差异。
목적：계통평개알전동예방심장외과술후심방전동（방전）유효성화안전성。방법계산궤검색중국생물의학문헌수거고（1978~2014.07）、중국기간전문수거고（1994~2014.07）、유보수거고（1999~2014.07）、만방수거고（1990~2014.07）、PubMed（1990~2014.07）、Cochrane Library（2014제07기）。안납입배제표준유량명연구자독립진행사선，병제취자료，채용개량적JADAD량표평개납입연구적질량후，채용RevMan 5.2연건진행Meta분석。결과공납입18편문헌，균위수궤대조연구，총공1964례환자。Meta분석결과현시：여안위제（대조조）상비，알전동（시험조）강저심장외과술후방전발생솔（RR=1.46，95%CI：1.36~1.57，P＜0.00001），이안전성무통계학차이（RR=1.16，95%CI：0.89~1.50，P=0.27）。아조분석현시，알전동불동급약방식화불동수차급약시간균대심장외과술후방전유효성무명현영향，여총유효성일치。결론여안위제상비，알전동가이유효지강저심장외과술후방전적발생솔，안전성무명현차이。
Objective To review systematically the efficacy and safety of amiodarone in prevention of atrial fibrillation (AF) after cardiac surgery.Methods The databases of CBM (from 1978 to July, 2014), CNKI (from 1994 to July, 2014), VIP Database (from 1999 to July, 2014), WanFang Database (from 1990 to July, 2014), PubMed (from 1990 to July, 2014) and Cochrane Library (No. 7 of 2014 Vol.) were retrieved with computer, and data was screened and extracted by 2 independently researchers according to inclusion and exclusion criteria. After reviewing the quality by using modified JADAD scale, the included data was given a Meta-analysis by using RevMan 5.2 software. Results There were totally 18 documents included (all were randomized controlled trials) involving 1964 cases. The results of Meta-analysis showed that compared with placebo (control group), amiodarone (test group) decreased the incidence rate of AF after cardiac surgery (RR=1.46, 95%CI: 1.36~1.57,P<0.00001), while the comparison in safety between 2 groups showed no statistical difference (RR=1.16, 95%CI: 0.89~1.50,P=0.27). The subgroup analysis showed that different administration ways and different first medication time had no significant influence on efficacy of amiodarone (consistent with the overall efficacy).Conclusion Amiodarone can effectively reduce the incidence rate of AF after cardiac surgery compared with placebo, while there is no difference in safety between them.