左西孟旦治疗急性右心衰患者临床疗效的系统评价

The clinical efficacy of levosimendan to treat acute right heart failure:a systematic review

目的系统评价左西孟旦治疗急性右心衰患者的临床疗效。方法检索PubMed、Medline、Springer等外文主要数据库以及中国知网、万方等中文数据库,收集有关左西孟旦治疗急性右心衰患者临床疗效的相关研究。应用Rev.Man 5.2软件进行meta分析,绘制森林图。对于计量资料选用标准化均数差值(Standardized mean difference,SMD)作为效应量。结果获得符合标准的研究文献11篇,共439例患者。Meta分析结果显示,两组三尖瓣环平面收缩期偏移(TAPSE)、收缩期肺动脉压(sPAP)、射血分数(EF)和肺血管阻力(PVR)的差异均具有统计学意义(各P<0.05)。结论左西孟旦治疗急性右心衰患者的临床疗效显著,但由于纳入研究数较少,其长期疗效尚不明确,仍需开展更多高质量的研究进一步验证两者的疗效。

Objective To systematically review the clinical efficacy of Levosimendan to treat patients with acute right heart failure. Methods We searched through foreign （Pubmed, Medline, Springer, etc） and domestic （CNKI, wanfang, etc） databases with the purpose of collecting related research papers about clinical efficacy of Levosimendan to treat patients with acute right heart failure. Valid data were analyzed with Meta-analysis using the Software RevMan 5.2 and drew forest plot. Choosing Standardized mean difference （SMD） was the effect quantity of measurement data. Results 11 trials and 439 patients were included. Results of Meta-analysis showed that the difference of tricuspid annular plane systolic excursion（TAPSE）, systolic pulmonary artery pressure（sPAP）, ejection fraction（EF） and pulmonary vascular resistance（PVR） between the two groups had statistical significance. SMD value and 95%CI were 1.53 （0.54, 2.53） ,- 6.15（-9.29, -3.02） ,3.59（1.21, 5.98） and -39.48 （-65.59, -13.38）, respectively. Conclusion The clinical efficacy of Levosimendan to treat patients with acute right heart failure is significant. However, the present study included a rela- tively small number of patients, and the long-term effects of Levosimendan remain unclear, more high-quality controlled trials are required.