法舒地尔注射液治疗慢性阻塞性肺疾病合并肺动脉高压的Meta分析

Meta Analysis of the Treatment of Fasudil Hydrochloride Injection to the Pulmanory Hypertension Related Chronic Obstructive Pulmonary Disease

目的利用Meta分析方法探讨法舒地尔注射液治疗慢性阻塞性肺疾病（chronic obstructive pulmonary disease，COPD）合并肺动脉高压（pulmanory arterial hypertention，PAH）的临床疗效。方法计算机检索MEDLINE／PubMed、中国知网、万方数据库和维普数据库，查找自建库至2014年11月公开发表关于法舒地尔注射液治疗COPD合并PAH的临床随机对照试验。按纳入及排除标准进行文献筛选、资料提取和质量评价后，使用RevMan5．2软件进行Meta分析。结果共纳入7项，总计624例COPD合并PAH患者。Meta分析结果表明在常规治疗的基础上，联用法舒地尔注射液的治疗组临床疗效优于常规对照组（OR=3．63，95％CI：2．58—5．78，P=0．000），并可以改善动脉血氧分压（Pa02）及肺动脉收缩压（pulmonary artery systolic pressure，PASP）（MD=13．14，95％CI：12．49～13．79，P=0．000；MD=5．27，95％CI：2．60—7．94，P=0．000）。结论COPD合并PAH患者在常规基础治疗的基础上联用法舒地尔注射液可明显改善患者的临床疗效，值得临床推广使用于临床。但由于质量与数量限制，为了进一步验证这种趋势，尚需开展更多设计严谨、多中心大样本的随机对照试验证实得出更为科学可靠的结论。

Objective To evaluate the curative effect of fasudil hydrochloride injection in the treatment of the pulmanory hypertension related COPD with Meta analysis method. Methods The databases of MEDLINE/PuhMed,CNKI,WanFang database and VIP database were retrieved with computer for searching the randomized controlled trials （RCT）about treatment of the pulmanory hypertension related COPD with routine therapies combining fasudil hydrochloride injection （treatment group） and with routine therapies only （ control group） published from database establishing time to Nov. 2014. After screening literature, data extracting and quality reviewing according to inclusion and exclusion criteria,the data were given a meta - analysis by using Review Manager 5.2 software. Results Totally 7 RCTs were included involving 624 patients. The results showed that the curative effect was better in treatment group than that in control group （ OR = 3.63,95 % CI： 2.58 - 5.78, P = 0. 000 ） , and PaO2 and PASP were improved in treatment group （ MD = 13.14,95 % CI： 12.49 - 13.79,P = 0. 000 ; MD = 5.27,95 % CI ： 2.60 - 7.94, P = 0. 000 ）. Conclusion The routine therapies combining fasudil hydrochloride injection has an improved curative effect on pulmanory hypertension related COPD,while more large -sample and multiple -center RCT with rigorous are required for further identifying this tendency because of limited quantity an quality of this study.