西地那非治疗肺动脉高压疗效评价的Meta分析

Efficacy of Sildenafil Therapy in Pulmonary Artery Hypertension:A Meta-Analysis

目的评价西地那非治疗肺动脉高压的疗效,为临床治疗提供参考。方法从中国期刊全文数据库和PubMed等中英文专业数据库中收录的2000年至2012年11月有关西地那非治疗肺动脉高压的病例对照研究,应用RevMan 5.1软件对数据进行Meta分析。结果共纳入9项研究,试验组与对照组的Meta分析结果为:(1)在改善肺动脉压方面差异有统计学意义,加权均数差为-14.32 mmHg,其95%可信区间为(-20.56,-8.08)mmHg,P<0.000 01;(2)在提高6分钟步行距离方面差异有统计学意义,加权均数差为62.78 m,其95%可信区间为(46.79,78.78)m,P<0.000 01;(3)在降低右心房压力方面差异无统计学意义,加权均数差为-3.30 mmHg,其95%可信区间为(-8.22,1.63)mmHg,P=0.19;(4)在提高心指数方面差异有统计学意义,其加权均数差为0.96L/(min·m2),95%可信区间为(0.91,1.01)L/(min·m2),P<0.000 01;(5)在降低呼吸困难指数方面差异无统计学意义,加权均数差为-0.28,其95%可信区间为(-2.36,1.79),P=0.79。结论西地那非在治疗肺动脉高压时,降低肺动脉压、提高6分钟步行距离、提高心指数的作用优于非西地那非组。

Objective To evaluate efficacy of Sildenafil in treatment of pulmonary hypertension, in order to guide the clinical work. Methods Study was conducted on the articles relating to the analysis of Sildenafil and pulmonary hypertension for comparisons and study from the China Journal Full-text Database and PubMed professional foreign language database collected from 2000 to November 2012. Chose the right articles, and analyzed it with RevMan 5.1 software. Results This article encompasses 9 studies. The meta-analysis results of the experimental group and the placebo group show that： （1） To improve the pulmonary artery pressure, there is statistically siguificance, WMD = -14.32 mmHg, 95%CI （-20.56, -8.08） mmHg, P〈0.000 01. （2） To increase the 6 minutes walking distance, there is statistical significance, WMD=62.78 m, 95%CI （46.79, 78.78） m, P〈0.000 01. （3） To reduce the right atrial pressure has no statistical significance, WMD=-3.30 mmHg, 95%CI （-8.22, 1.63） mmHg, P=0.19. （4） To increase the cardiac index is statistically significant, WMD=0.96 L/（min＇m2）, 95%CI （0.91, 1.01） L/（min.m2）, P〈0.000 01. （5） To reduce the dyspnea index has no statistical significance, WMD=-0.28, 95% CI （-2.36, 1.79）, P=0.79. Conclusion Sildenafil in the treatment of pulmonary hypertension to reduce pulmonary artery pressure, enhance the 6 minutes walking distance and cardiac index produced better efficacy than in the non-Sildenafil group.