米力农治疗国人慢性阻塞性肺疾病心力衰竭疗效及安全性的系统评价

Systematic review of curative effect analysis on Chinese chronic pulmonary heart failure treated with milrinone

目的 评价国内有关米力农治疗国人慢性阻塞性肺疾病心力衰竭疗效及安全性.方法 计算机检索中国生物医学文献数据库、中国期刊全文数据库、万方数据库、重庆维普数据库等中文数据库,以“米力农”、“心力衰竭”、“肺源性心脏病”为关键词,手工检索部分中文文献,文献检索年限2005～2013年,收集有关米力农治疗国人慢性阻塞性肺疾病心力衰竭的随机对照试验,有两名评价员检索资料并交叉核对,利用Cochrane系统评价手册中的质量评价量表,对纳入的所有随机对照试验（RCT）文献进行质量评分；统计学处理采用Cochrane协作网的RevMan 4.2软件进行Meta分析.结果 初步检索相关文献275篇,阅读全文及质量评价后,最终纳入9项研究,包括患者612例,米力农治疗组314例,对照组298例,米力农治疗组临床有效率明显高于对照组,其差异有统计学意义.结论 米力农对国人慢性阻塞性肺疾病心力衰竭有明显疗效,短期用药不良反应少,比较安全；本研究仅能说明米力农短期临床疗效满意,米力农远期疗效如何还待进一步研究探讨.但由于国内大部分文献方法学质量差,同时因对不良反应观察样本数有限,这一结论尚需更多设计严格的高质量研究加以证实.

Objective To evaluate the curative effect analysis on Chinese chronic pulmonary heart failure treated with mlrinone. Methods Acording to the method provided by the international Cochran Coordination Net, Electronic searches on Chinese Biomedical Databese（CBMdisc） ,Chinese National Knowledge Infrastructure （CNKI） , Wanfang data ~ Chinese VIP Information Database, as well as a manual search of published and unpublished literatures was carried out for the inclusion of the data into RCTs for curative effect on Chinese chronic pulmonary heart failure treated with milrinone. Results Nine trials evaluated the curative effect analysis on chinese chronic pulmonary heart failure treated with milrinone. A total of 9 trials involved 612 patients were included in the recta-analysis, a significant beneficial effect on curative effect （OR 5.11, 95% CI 3.21 to 8.12）. The total effective rate was 91.40% in theraphy group and 67.45% in control group with significant difference, several adverse events were reported. Conclusion The milrinone might be effective to treat Chinese chronic pulmonary heart failure, are we]] tolerated, and should he advocated. Accordingly, more well designed randomised clinical trials of sufficient size are needed to address the question of the curative effect analysis on Chinese chronic pulmonary heart failure treated with milrinone.