伊布利特与胺碘酮治疗心房颤动的Meta-分析

Meta-analysis of iblitide and amiodarone for atrial fibrillation

目的系统评价伊布利特与胺碘酮治疗心房颤动的有效性与安全性。方法检索中国学术期刊全文数据库(CNKI)、中国生物医学文献数据库(CBM)、维普中文期刊全文数据库(VIP)、万方数据库、PubMed、Embase和Cochrane Library,检索时间均为建库至2019年6月。纳入伊布利特与胺碘酮比较治疗房颤的随机对照试验(RCTs),由两名研究员独立筛选并提取资料,采用Cochrane标准进行评价,运用RevMan 5.3软件进行Meta-分析。结果最终纳入18篇RCTs进行Meta-分析,结果显示伊布利特组较胺碘酮组治疗房颤的有效性(OR=2.65,95%CI=2.03~3.46,P<0.00001)、房颤转复时间(WMD=-21.54,95%CI=-24.73^-18.34,P<0.00001)均优于胺碘酮组;两组治疗房颤安全性比较差异无统计学意义(RR=0.74,95%CI=0.46~1.18,P=0.20),但胺碘酮组不良反应发生率(18.36%)稍高于伊布利特组(16.18%)。结论伊布利特对房颤转复的有效率显著高于胺碘酮,转复时间亦较胺碘酮短,在安全性方面二者无显著差异。由于纳入样本量较少,以后研究中仍需大样本、高质量的RCT进一步确认以期得到可靠的结果。

Objective To review systematically the efficacy and safety of ibutilide and amiodarone intreatment of atrial fibrillation.Methods The databases of CNKI,CBM,VIP,Wan Fang Data,PubMed,Embase and Cochrane Library the retrieval time was to build the database to June 2019.Include randomized controlled trials comparing iblitide with amiodarone in the treatment of atrial fibrillation.The data were independently selected and extracted by two researchers,evaluated using Cochrane’s criteria,and Metaanalysis was performed using RevMan 5.3 software.Results Finally included 18 RCTs for Meta-analysis.The results of Metaanalysis showed that efficacy of iblitide group in treating atrial fibrillation compared with amiodarone group(OR=2.65,95%CI=2.03~3.46,P<0.00001)、atrial fibrillation recovery time(WMD=-21.54,95%CI=-24.73^-18.34,P<0.00001)was better than the amiodarone group;There was no significant difference in the safety of atrial fibrillation between the ibutilide group and the amiodarone group(RR=0.74,95%CI=0.46~1.18,P=0.20).However,the incidence of adverse reactions in the amiodarone group(18.36%)was slightly higher than that in the ibutilide group(16.18%).Conclusion Ibutilide was significantly more effective in converting atrial fibrillation than amiodarone,the conversion time was shorter than that of amiodarone.and they have no difference in safety.Due to the small number of included samples,large samples and high-quality RCTs are still needed for further confirmation in future studies in order to obtain reliable results.