重组人脑利钠肽联合左西孟旦治疗急性心力衰竭病人护理相关指标的Meta分析

Meta-analysis of nursing related indexes of recombinant human brain natriuretic peptide with levosimendan in the treatment of patients with acute heart failure

[目的]对重组人脑利钠肽(rhBNP)联合左西孟旦(Levo)治疗急性心力衰竭(AHF)病人的护理相关指标进行系统性评价。[方法]通过PubMed、Cochrane Library、EMBASE、中国知网、中文科技期刊全文数据库、中国生物医学文献数据库检索有关rhBNP联合Levo治疗AHF的随机对照试验,时间从建库至2016年11月。采用改良后JADAD量表进行文献质量评价,采用RevMan 5.3.1软件进行统计分析。[结果]共纳入8篇随机对照试验文献,其中英文文献1篇,中文文献7篇。Meta分析结果显示:rhBNP联合Levo治疗AHF能够降低病人呼吸频率[MD=-1.35,95%CI(-2.67,-0.02),P=0.05]和收缩压[MD=-3.43,95%CI(-6.04,-0.83),P=0.010],升高动脉血氧饱和度[MD=0.77,95%CI(0.20,1.34),P=0.008],缩短心脏病监护病房住院时间[MD=-4.70,95%CI(-6.96,-2.44),P<0.000 1],不会增加不良反应[RR=1.06,95%CI(0.76,1.50),P=0.72]。[结论]rhBNP联合Levo治疗AHF可明显改善病人生命体征,缩短心脏病监护病房住院时间,且不会增加不良反应,但由于纳入研究数量与质量限制,需在此方面开展高质量、大样本、多中心的随机对照试验予以验证。

Objective：To evaluate patients＇ nursing related indexes of recombinant human brain natriuretic peptide（rhBNP）with levosimendan（Levo）in the treatment of patients with acute heart failure（AHF）.Method：Databases including PubMed,Cochrane Library,EMBASE,CNKI,VIP,CBM were searched electronically from inception to November 2016 to collect the randomized controlled trials（RCTs）about rhBNP with Levo in the treatment of patients with AHF.The quality of literatures were evaluated by improved JADAD scale.Meta analysis was performed using RevMan 5.3.1 software.Results：A total of 8 RCTs were included,of which 1 was written in English and 7 in Chinese.Meta analysis showed that rhBNP with Levo in the treatment of patients with AHF could reduce respiratory rate[MD=-1.35,95 CI（-2.67,-0.02）,P=0.05],systolic pressure[MD=-3.43,95%CI（-6.04,-0.83）,P=0.010],improve arterial oxygen saturation[MD=0.77,95%CI（0.20,1.34）,P=0.008],shorten the time of cardiopathy intensive care unit hospitalization[MD=-4.70,95%CI（-6.96,-2.44）,P0.000 1]without increasing adverse reactions[RR=1.06,95%CI（0.76,1.50）,P=0.72].Conclusion：rhBNP with Levo in the treatment of patients with AHF could improve patient＇s vital signs,shorten the time of cardiopathy intensive care unit hospitalization without increasing adverse reactions.But it was limited by the quality and quantity of included researches so it needs to be verified by randomized controlled trials of high quality,large sample and multicenter.