| 欧阳爱军,刘岭青.曲美他嗪治疗慢性肺源性心脏病随机对照试验的系统评价[J].井冈山大学自然版,2017,(1):97-102 |
| 曲美他嗪治疗慢性肺源性心脏病随机对照试验的系统评价 |
| TRIMETAZIDINE FOR CHRONIC COR PULMONALE: A SYSTEMATIC REVIEW OF RANDOMIZED CONTROLLED TRIALS |
| 投稿时间：2016-10-10 修订日期：2016-12-02 |
| DOI：10.3969/j.issn.1674-8085.2017.01.019 |
| 中文关键词: 曲美他嗪 慢性肺源性心脏病 随机对照实验 系统评价 |
| 英文关键词: trimetazidine chronic cor pulmonale randomized controlled trial systematic review |
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| 中文摘要: |
| 目的 系统评价曲美他嗪治疗慢性肺源性心脏病的疗效与安全性。方法 采用Cochrane协作网系统评价方法，计算机检索PubMed、维普、中国知网、万方、中国生物医学数据库等，检索时间截至2015年11月1日，收集实验组（曲美他嗪联合常规治疗方法）对比对照组（仅用常规治疗方法）治疗慢性肺源性心脏病的随机对照实验（RCT）。由2名研究员按照纳入与排除标准提取RCT的资料，采用改良Jadad评分量表法评价纳入RCT的方法学质量，采用RevMan5.3软件对临床同质性RCT进行Meta分析，采用“倒漏斗”图对潜在偏倚进行分析。结果 共纳入8个RCT，668例慢性肺源性心脏病患者。Meta分析结果显示：实验组的疗效明显优于对照组，其中总有效率[RR=1.21，95% CI（1.11，1.31），P<0.0001]、PaO2改善情况[MD=8.98，95% CI（7.84，10.12），P<0.00001]、PaCO2改善情况[MD=-5.95，95% CI（-7.18，-7.41），P<0.00001]、左室射血分数[MD=0.08，95% CI（0.06，0.10），P<0.00001]、心脏指数[MD=0.08，95% CI（0.06，0.10），P<0.00001]、心输出量[MD=0.52，95% CI（0.43，0.60），P<0.00001]差异均有统计学意义，而脑钠肽差异无统计学意义[MD=-12.54，95% CI（-37.52，12.45），P=0.33]。结论 基于现有研究证据，表明在常规治疗基础上加用曲美他嗪治疗慢性肺源性心脏病时，其疗效优于仅采用常规治疗，但因受纳入研究数量和质量不足的影响，仍需更多大样本多中心的研究。 |
| 英文摘要: |
| Objective: To evaluate the effect of trimetazidine on chronic pulmonary heart disease, such as efficacy and safety. Methods: We searched Cochrane Controlled Trials Register, PubMed, CBM database, CNKI, WanFang Data, VIP database, and so on. All searches were updated on November 1, 2015. At least two reviewers independently screened the studies for eligibility, evaluated the quality, and extracted the data from the eligible literatures, with a cross-check to confirm accuracy. Results: 8 RCTs were included and analyzed, the results illustrated: compared to the common therapy, the total effective number [RR=1.21, 95%CI(1.11,1.31), P<0.0001], PaO2 [MD=8.98, 95%CI(7.84,10.12), P<0.00001], PaCO2 [MD=-5.95, 95%CI(-7.18,-7.41), P<0.00001], Left ventricular ejection fraction [MD=0.08, 95%CI(0.06,0.10), P<0.00001], Cardiac index [MD=0.08, 95%CI(0.06,0.10), P< 0.00001], Cardiac output [MD=0.52, 95%CI(0.43,0.60), P<0.00001] had significant difference, and there was no significant difference in average time of disappearance of Brain natriuretic peptide [MD=-12.54,95%CI(-37.52,12.45), P=0.33]. Conclusion: The common treatment pulse phentolamine is superior than the common treatment, but with the lack of evidence on the safety, it needs further studies. |
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