乌拉地尔与硝酸甘油比较治疗高血压合并急性心力衰竭的Meta分析

Comparison of Urapidilb and Nitroglycerin in the Treatment of Hypertension with Acute Heart Failure: A Meta-analysis

目的:系统评价乌拉地尔与硝酸甘油比较治疗高血压合并急性心力衰竭的疗效及安全性。方法:通过计算机检索中国生物医学文摘数据库(CBM)、维普数据库(VIP)、中国期刊全文数据库(CNKI)、万方等数据库,收集有关乌拉地尔与硝酸甘油比较治疗高血压合并急性心力衰竭的临床随机对照试验(RCT),时间为建库至2019年1月。由2名评价员对纳入的研究进行资料提取和质量评价,并采用RevMan5. 3软件进行Meta分析。结果:纳入19篇研究,共2364例患者,Meta分析结果显示:乌拉地尔组在降低患者收缩压、舒张压、心率及改善患者左心射血分数(LVEF)、左心室收缩末期容积(LVESV)、左心室舒张末期容积(LVEDV)以及不良反应等方面均优于硝酸甘油组(P <0. 05)。在改善患者左心室收缩末期内径(LVESD)方面,两组比较无统计学意义(P> 0. 05)。结论:乌拉地尔治疗高血压合并急性心力衰竭疗效优于硝酸甘油,且安全性更高。

Objective: To systematically evaluate the efficacy and safety of urapidil and nitroglycerin in the treatment of hypertension with acute heart failure. Methods: The CBM,CNKI,VIP and Wanfang databases w ere retrieved by the computer. To collect a randomized controlled trial( RCT) comparing urapidil w ith nitroglycerin in the treatment of hypertension w ith acute heart failure. The retrieval time is from January 2019. The data extraction and quality evaluation w ere performed on the included studies by 2 review ers,and meta-analysis w as performed using RevM an5. 3 softw are. Results: A total of 2364 patients w ere included in 19 studies. M eta analysis results show ed that: the ulaidil group w as superior to the nitroglycerin group in reducing patients’ systolic blood pressure,diastolic blood pressure and heart rate,and w as superior to the control group in improving left ventricular ejection fraction( LVEF),left ventricular end-systolic volume( LVESV),left ventricular end-diastolic volume( LVEDV) and adverse reactions,the differences w ere statistically significant( P < 0. 05). In terms of improving patients’ LVESD,there w as no statistical significance betw een the tw o groups( P >0. 05). Conclusion: Urapidil is superior to nitroglycerin in the treatment of hypertension w ith acute heart failure and has higher safety.