血管紧张素Ⅱ受体拮抗剂联合胺碘酮在阵发性心房颤动中的治疗效果:Meta-分析

Efficacy of angiotensin Ⅱ receptor blocker plus amiondarone in the treatment of paroxysmal strial fibrillation:a Meta-analysis

目的评价血管紧张素Ⅱ受体拮抗剂联合胺碘酮在阵发性心房颤动中的治疗效果。方法计算机检索EMBASE(1989～2010年),Medline(1966～2010年),SpringerLink Online Journals外文数据库,以及中国生物医学文献数据库(CBM)(1978～2010年)、万方数据库(1982～2010年)等中文数据库中关于血管紧张素II受体拮抗剂联合胺碘酮治疗阵发性心房颤动的随机对照试验,并对文献的质量做出了初步的评价,同时也对所纳入的文献进行了筛选,对符合标准的随机对照试验进行Meta分析。结果共纳入9篇文献,随访的总人数为1 073人,其中试验组有545人,对照组有528人。与对照组相比,试验组治疗后患者的左心房内径明显变小[WMD=-2.21,95%CI(-2.64,-1.79)],窦性心律维持率明显提高[OR=3.02,95%CI(2.28,4.01)];2个指标治疗前后差异均有统计学意义(P<0.05)。结论血管紧张素Ⅱ受体拮抗剂联合胺碘酮治疗阵发性心房颤动在延缓患者左心房内径的扩大,以及窦性心律的维持方面效果均优于单用胺碘酮。

Objective To evaluate the efficacy of angiotensin II receptor blocker plus amiondarone in the treatment of paroxysmal strial fibrillation. Methods We searched the following electronic databases：EMBASE（ 1989 -2010 year）, Medline （1966-2010 year）, SpringerLink Online Journals and China Biology Medicine disc （1978 -2010 year）, Wanfang Database （1982 -2010 year）to collect randomized controlled trials（RCTs）. The quality of RCTs was appraised and data were extracted carefully. Meta-analysis were conducted for the eligible RCTs. Results Nine RCTs involving 1 073 patients were included,and 545 patients were in the experimental group, while 528 were in the control group. Compared with control group, the left atrial di- ameter of patients in experiment group were smaller[ WMD = -2.21,95% CI （ -2.64, -1.79 ）] and the maintenance rates of sinus rhythm were higher[ OR = 3.02,95% CI（2. 28,4. 01 ） ]. These two index all have statistical significance（ P 〈 0.05 ）. Conclusion The efficacy of angiotensin II receptor blocker plus amiodarone in the treatment of paroxysmal atrial fibrillation was better than amiodarone alone in delaying the enlargement of left atrial diameter,as well as the maintenance of sinus rythm.