摘要
目的评价左西孟旦治疗心力衰竭的临床疗效和安全性。方法计算机检索中国知网（CNKI）、中国生物医学文献光盘数据库（CBMdisk）、维普中文科技期刊数据库（VIP）、万方数据库、PubMed和Cochranelibrary中有关左西孟旦（左西孟旦组）与其他某一种药物（多巴酚丁胺或米力农或呋塞米或安慰剂，对照组）治疗心力衰竭的疗效对比研究。应用RevMan5．2．4软件对各项随机对照研究的左心室射血分数（LVEF）、B型脑钠肽（BNP）水平、每搏量（SV）、左心室舒张末内径（LVEDD）和临床疗效进行Meta分析。结果共纳入12个临床随机对照研究，共699例患者，与对照组相比，左西孟旦组的临床疗效显著提高（RR=3．27，95％CI为1．81～5．92，P〈O．0001），LVEF[-加权均数差（WMD）=3．72，95％CI为2．84～4．61]、SV值（WMD=10．78，95％CI为5．27～16．29）均显著升高（P值均〈O．0001），BNP水平显著降低（WMD=458．48，95％CI为395．55～521．42，P〈0．01），LVEDD的差异无统计学意义（WMD=0．92，95％CI为-0．73～2．58，P=0．27）。8篇文献提及具体不良反应，经减小药物剂量等处理后症状消失。结论应用左西孟旦治疗心力衰竭安全、可靠，值得在临床推广应用。
Objective To evaluate the safety and efficacy of levosimendan injection for heart failure. Methods The literatures on randomized controlled trials （ROTs） between levosimendan and placebos （dobutamine, milrinone, frusemide, etc） for treating heart failure were searched in China National Knowledge Infrastructure （CNKI）, Chinese Biomedical disk （CBMdisk）, VIP Chinese periodical database （VlP）, Wanfang database, PubMed and Oochrane library. The left ventricular ejection fraction （LVEF）, brain natriuretic peptide （BNP）, stroke volume （SV）, left ventricular end diastolic diameter （LVEDD） and clinical outcome were investigated by RevMan 5.2.4 software for meta-analysis. Results Eventually, 12 ROTs （699 patients） were enrolled in the study. Compared with control group, clinical symptOms were significantly improved after levosimendan application （RR=3.27, 95%C1= 1.81-5.92, P〈0.000 1）; LVEF （WMD=3.72, 95%01= 2.84 - 4.61 ） and SV （ WMD = 10.78, 95% CI ： 5.27 - 16.29） Were significantly increased （both P〈0. 000 1 ）; BNP level was significantly decreased （ WMD -- 458.48, 95 % CI： 395.55 - 521.42, P 〈 0.01 ）; but LVEDD was not reduced （WMD= 0.92, 95 % OI = - 0.73 - 2.58, P = 0.27）. Adverse reaction related to levosimendan injection was mentioned in 8 trials, but the symptoms disappeared after reducing the dose of levosimendan. Conclusion Levosimendan is safe and reliable in the treatment of heart failure. It can be widely used in clinic. （Shanghai Med J, 2015, 38： 26-31）
出处
《上海医学》
CAS
CSCD
北大核心
2015年第1期26-31,共6页
Shanghai Medical Journal
