摘要
目的评价美托洛尔治疗慢性心力衰竭的有效性。方法计算机检索2000年至2015年1月Pubmed、Embase、万方数据库、中国学术期刊全文数据库(CNKI)、维普数据库(VIP),收集美托洛尔治疗慢性心力衰竭的随机对照试验(RCTs),按纳入和排除标准由2名评价者独立选择试验、提取资料,交叉核对并进行方法学质量评估。使用RevMan5.3软件进行Meta分析。结果共纳入7项研究,582例患者。结果显示,常规治疗基础上联用美托洛尔治疗慢性心力衰竭显著优于常规治疗对照组(RR=4.83,95%CI2.72~8.58.P〈0.01);联用美托洛尔可增加射血分数(LVEF)(WMD=7.11,95%CI6.44~7.77,P〈0.01);降低左室舒张末期内径(LVEDD)(WMD=-4.89,95%CI-5.58~-4.19,P〈0.01);降低左室收缩末期内径(LVESD)(WMD=-3.68,95%CI-4.59~-2.78,P〈0.01);降低BNP(WMD=-211.58,95%CI-222.71~-200.45,P〈0.01)。结论现有证据显示,联合美托洛尔治疗可改善慢性心力衰竭临床疗效及心功能指标。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。
Objective To review the effectiveness of Metoprolol in the treatment of chronic heart failure (CHF). Methods The databases of PubMed, Embase, Infrastructure (CNKI) and VIP Database were retrieved WanFang Database, China National Network Knowledge with computer for collecting randomized controlled trials (RCTs) about the treatment of CHF with Metoprolol from 2000 to January 2015. All data was selected, extracted, cross-checked and given methodological quality evaluation by two independent reviewers according to inclusion and exclusion criterions, and then a Meta-analysis was conducted by using RevMan 5.3. Results There were totally 7 RCTs included involving 582 patients. The results showed that the curative effect on CHF was significantly better in group combining routine therapy and Metoprolol (combining group) than that in control group (RR=4.83, 95%17,1 2.72-8.58, P〈0.01 ). In combining group, LVEF increased (WMD=7.11, 95%CI 6.44-7.77, P〈0.01). LVEDD decreased ( WMD=-4.89, 95%CI -5.58--4.19, P〈0.01 ). LVESD decreased (WMD=-3.68, 95%CI -4.59--2.78, P〈0.01 ). BNP decreased ( WMD=-211.58, 95%CI -222.71 --200.45, P〈0.01 ). Conclusion The existing evi- dences indicate that Metoprolol can improve the curative effect and cardiac functional indexes. Due to the limitation of the included studies, more large-sample, multiple-center and high-quality RCTs are required.
出处
《中国心血管病研究》
CAS
2015年第7期617-620,共4页
Chinese Journal of Cardiovascular Research
基金
湖北省基金重点项目(项目编号:2014CFA061)