β受体阻滞剂治疗射血分数保留心力衰竭疗效的Meta分析

A meta-analysis of beta-blocker in the treatment of heart failure with preserved ejection fraction

目的:通过对观察性队列研究和随机对照临床试验进行meta分析,评估β受体阻滞剂对射血分数保留的心力衰竭(HFpEF)患者的再住院率和病死率的影响。方法:计算机检索Pubmed、The Cochrane Libary、Web of Science、Embase、中国生物医学期刊库(CBM)、中国知网(CNKI)、万方、维普数据库,检索时限从建库至2019年4月。由两名研究者按照纳入和排除标准独立检索和筛选文献,提取资料,对纳入研究进行质量评价后采用STATA15.0进行统计分析。结果:共纳入16篇文献,共计36 067例受试者。Meta分析结果显示:与未服用β受体阻滞剂组相比,服用β受体阻滞剂组分别与全因死亡风险下降25%、心血管病原因死亡风险下降32%显著相关(HR=0.85,95%CI 0.79~0.91;HR=0.68,95%CI 0.57~0.82)。结论:在对心力衰竭患者采用标准治疗的基础上,加用β受体阻滞剂有益于提高HFpEF患者的生存率。

Objective:To investigate the effect of beta-blocker on readmission and mortality in patients with heart failure with preserved ejection fraction by a meta-analysis of observational cohort studies and randomized controlled clinical trials.Method:Literature published until April 2019 were independently searched and screened by two researchers according to the inclusion and exclusion criteria using Pubmed,The Cochrane Library,Web of Science,Embase,CBM,CNKI,WANFANG and VIP database.STATA 15.0 was used for statistical analysis after data extracting and quality evaluation of the included studies.Result:A total of 16 articles including 36 067 subjects were included.Meta-analysis results showed that the group with beta blocker was significantly associated with 25% reduction in the risk of all-cause death and 32% reduction in the risk of cardiovascular death,respectively(HR=0.85,95%CI 0.79-0.91;HR=0.68,95%CI 0.57-0.82),compared with the group without beta blocker treatment.Conclusion:Addition of beta blocker to standard treatment can improve the survival of heart failure with preserved ejection fraction patients.