β受体阻滞剂应用于慢性阻塞性肺疾病治疗的Meta分析

Meta-analysis of beta-blockers for chronic obstructive pulmonary disease

目的评价心脏选择性β受体阻滞剂对于慢性阻塞性肺疾病患者肺功能的影响。方法计算机检索PUBMED(1980年至2011年7月)、Cochrane Library(2011年第3期)等西文数据库及中国知网(1990年至2011年7月)、万方数据库(1990年至2011年7月)等中文数据库,收集心脏选择性β受体阻滞剂用于慢性阻塞性肺疾病患者的相关文献,按纳入与排除标准筛选随机对照试验。评价质量及提取资料后,采用RevMan 5.1软件对数据进行Meta分析。结果共检索到文献61篇,经筛选最终纳入7篇,共378例慢性阻塞性肺疾病患者。各研究间无异质性,采用固定效应模型进行效应量合并。Meta分析结果显示,用药后,β受体阻滞剂组的FEV1值(一秒用力呼气容积)较安慰剂组降低0.03 L[95%CI(-0.07,0.02)],FEV1占预计值百分比(FEV1%)值较安慰剂组升高0.89%[95%CI(-1.26,3.04)],两组间差异无统计学意义。讨论心脏选择性β受体阻滞剂不会对慢性阻塞性肺疾病患者的呼吸功能产生不利的影响。

Objective To assess the effect of cardioselective beta-blockers on respiratory function of patients with chronic obstructive pulmonary disease（COPD）.Methods Pubmed（1990 to July 2011）,Cochrane Library（Issue 3,2011）,CNKI（1990 to July 2011） and WANFANG database（1990 to July 2011） were searched.Randomized controlled trials（RCTs） data in which cardioselective beta-blockers were used to treat patients with COPD were collected.Then the retrieved studies according to inclusion and exclusion criteria were screened,the quality of the included studies was evaluated,and meta-analyses by RevMan 5.1 software was performed.Results A total of 61 articles were found and 7 articles inolving 378 patients were finally included.We chose the fixed-effect model to conduct meta-analysis because heterogeneities were not found among these articles.Compared with placebo group,FEV1 decreased 0.03L[95%CI（-0.07,0.02）,P0.05] and FEV1% increased 0.89%[95%CI（-1.26,3.04）,P0.05] after treatment with beta-blockers.Conclusion Cardioselective beta-blockers do not produce obvious adverse respiratory effects.