胺碘酮与维拉帕米静脉注射治疗阵发性室上性心动过速疗效对比的Meta分析

Curative effect of intravenous injections of amiodarone and verapamil on paroxysmal supraventricular tachycardia:a Meta-analysis

目的比较静脉注射胺碘酮与维拉帕米在治疗阵发性室上性心动过速疗效、安全性及复律时间上的差异。方法收集2005-01~2015-12公开发表的有关两种药物在治疗阵发性室上性心动过速的中文和英文文献,按标准严格筛选后,评估文献质量并提取完整数据资料,最后应用Rev Man 5.20软件进行系统分析评价。结果最终纳入随机对照试验资料10篇,Meta分析结果显示,静脉注射胺碘酮组与维拉帕米组相比在治疗阵发性室上性心动过速疗效上差异无统计学意义(OR=0.73,95%CI=0.35~1.53,P=0.41);胺碘酮组不良反应发生率低于维拉帕米组,差异有统计学意义(OR=0.34,95%CI=0.21~0.57,P<0.01);两药治疗阵发性室上性心动过速在复律时间上,维拉帕米优于胺碘酮,差异有统计学意义(OR=7.90,95%CI=3.35~12.44,P<0.01)。结论与维拉帕米相比,胺碘酮在治疗阵发性室上性心动过速上具有更好的安全性、可靠性,但复律时间慢于维拉帕米。

Objective To evaluate the clinical effects of intravenous injections of amiodarone and verapamil on the treatment of paroxysmal supraventricular tachycardia（PSVT）.Methods Medical articles of randomized controlled trials published in Chinese and English about the treatment of PSVT were searched in the Cochrane library and on the databases of Pub Med,EMBASE,CNKI,VIP and Wangfang from January 2005 to December 2015,with a strictly screening according to the standard of assessing the quality of the literatures.The data of the selective trials were analyzed by the Rev Man 5.20 software.Results A total of ten randomized clinical trials were included.The Meta-analysis showed that there was no significant difference between the amiodarone group and the verapamil group in the curative effect of PSVT（OR = 0.73,95% CI = 0.35 - 1.53,P = 0.41）; The incidence of adverse reactions of the amiodarone group was significantly lower than that of the verapamil group（OR = 0.34,95% CI = 0.21 - 0.57,P〈0.01）; The cardioversion time of PSVT in the verapamil group was significantly shorter than that in the amiodarone group（OR = 7.90,95% CI = 3.35 - 12.44,P〈0.01）.Conclusion Amiodarone is more safe and reliable than verapamil in the treatment of PSVT.The cardioversion time of amiodarone is longer than that of verapamil.