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曲美他嗪联合美托洛尔治疗冠心病伴心力衰竭效果和安全性的系统评价 被引量:37

Systematic review of efficacy and safety of Trimetazidine combined with Metoprolol in treatment of coronary heart disease complicated with heart failure
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摘要 目的系统评价曲美他嗪联合美托洛尔治疗冠心病伴心力衰竭患者的有效性和安全性。方法计算机检索Ovid Medline、EMBase、Cochrane Library、CNKI、CBM、VIP和Wan Fang Data,检索时限均从建库至2018年6月,采用Rev Man 5.3软件对纳入研究进行Meta分析。结果纳入26项随机对照实验(RCT),共2691例患者,其中试验组1346例,对照组1345例。Meta分析结果表明:试验组左室射血分数改变值(ΔLVEF)[MD=-5.15,95%CI:-5.80~-4.50,P<0.01]、6 min步行距离改变值(Δ6MWT)[MD=-43.68,95%CI:-55.70~-31.66,P<0.01]、总有效率[RR=1.18,95%CI:1.14~1.23,P<0.01]、左室收缩末期内径改变值(ΔLVESD)[MD=5.09,95%CI:4.39~5.79,P<0.01]、左室舒张末期内径改变值(ΔLVEDD)[MD=4.76,95%CI:4.05~5.48,P<0.01]的效果均优于对照组。试验组总有效率高于对照组,差异有高度统计学意义(P<0.01)。两组药物不良反应(ADR)发生率比较,差异无统计学意义(P>0.05)。结论曲美他嗪联合美托洛尔可改善冠心病伴心力衰竭患者的心功能,且不增加安全风险。 Objective To systematically evaluate the efficacy and safety of Trimetazidine combined with Metoprolol in treatment of patients with coronary heart disease complicated with heart failure. Methods Databases including Ovid Medline, EMBase, Cochrane Library, CNKI, CBM, VIP and Wan Fang Data were retrieved from database foundation to June 2018 by computer. Meta analysis was performed on the included studies by Rev Man 5.3 software. Results A total of 26 RCTs involving 2691 cases were included, with 1346 cases in experimental group and 1345 cases in control group. The results of meta-analysis showed:ΔLVEF [MD =-5.15, 95%CI:-5.80--4.50, P < 0.01],Δ6 MWT [MD =-43.68, 95%CI:-55.70--31.66, P < 0.01], total effective rate [RR = 1.18, 95%CI: 1.14-1.23, P < 0.01],ΔLVESD [MD =5.09, 95%CI: 4.39-5.79, P < 0.01 and ΔLVEDD] and ΔLVEDD [MD = 4.76, 95%CI: 4.05-5.48, P < 0.01] of experimental group were statistically better than that of control group. Total effective rate in experimental group was higher than control group, the difference was highly statistically significant(P < 0.01). There was no statistically significant difference in the incidence of adverse drug reactions(ADR) between two groups(P > 0.05). Conclusion Trimetazidine combined with Metoprolol can improve the cardiac function of patients with coronary heart disease complicated with heart failure without increasing the incidence of ADR.
作者 蔡旭阳 金朝辉 吴斌 罗敏 徐珽 CAI Xuyang;JIN Zhaohui;WU Bin;LUO Min;XU Ting(Department of Clinical Pharmacy, West China Hospital of Sichuan University, Sichuan Province, Chengdu 610041, China;West China School of Pharmacy, Sichuan University, Sichuan Province, Chengdu 610041, China)
出处 《中国医药导报》 CAS 2019年第7期136-139,共4页 China Medical Herald
基金 四川省医学会高血压疾病(施慧达)专项科研课题(2017SHD005) 四川省医学会"施慧达"科研课题(SHD12-02)
关键词 曲美他嗪 美托洛尔 冠心病 心力衰竭 系统评价 Trimetazidine Metoprolol Coronary heart disease Heart failure Systematic review
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