美托洛尔治疗老年慢性心力衰竭患者Meta分析

Meta-analysis of metoprolol in the treatment of elderly patients with chronic heart failure

目的 Meta分析美托洛尔治疗老年慢性心力衰竭患者的效果。方法选取符合慢性心力衰竭的诊断标准,有慢性心力衰竭的症状体征,年龄均在60岁以上的患者,对照组患者接受常规治疗,实验组患者在常规治疗基础上接受美托洛尔治疗,然后统计分析临床疗效、不良反应发生情况。检索文献、提取资料、评价质量、进行统计学分析。结果初检出中文文献468篇、英文文献36篇,对文章题目、摘要进行阅读后筛选出312篇文献,阅读全文、评价质量后依据纳入与排除标准共纳入9篇,共760例患者,其中实验组385例,对照组375例。5篇质量为C级,4篇质量为B级。纳入9篇文献均对临床疗效进行了报道,由于其效应量差异无统计学意义(c2=1.17,P>0.05),因此Meta分析过程中采用固定效应模型,实验组患者的有效率显著高于对照组[RR(95%CI)=1.23(1.15~1.32),P<0.05]。纳入9篇文献均对不良反应发生率进行报道,共有42例患者发生不良反应,不良反应发生率为5.53%,其中19例为胸闷、心动过缓、乏力,2例为双下肢水肿加重,5例为二度房室传导阻滞,分别占2.50%、0.26%、0.66%。由于其效应量差异无统计学意义(c2=0.91,P>0.05),因此Meta分析过程中采用固定效应模型,发现实验组患者的不良反应发生率显著高于对照组[RR(95%CI)=10.17(3.92~26.37),P<0.05]。结论美托洛尔治疗老年慢性心力衰竭患者的临床疗效显著,但是具有较多的不良反应。

Objective Meta-analysis of the efficacy of metoprolol in the treatment of elderly patients with chronic heart failure. Methods The diagnostic criteria for chronic heart failure were selected. There were symptoms and signs of chronic heart failure. Patients with ages above 60 years old, patients in the control group received routine treatment, and patients in the experimental group received metoprolol based on conventional treatment. Statistical analysis of its clinical efficacy, adverse reactions occurred. Search literature, extract data, evaluate quality, and perform statistical analysis. Results At the beginning, 468 Chinese documents and 36 English documents were detected. After reading the articles and abstracts, 312 articles were selected. After reading the full text and evaluation quality, 9 articles were included according to the inclusion and exclusion criteria, a total of 760 cases patients, including 385 cases and 375 cases in the experimental group and the control group. 5 articles quality is grade C, 4 articles quality is grade B. The clinical efficacy was reported in 9 articles. Because the effect amount was not statistically heterogeneous(c2=1.17, P>0.05), the fixed effect model was used in the meta-analysis process, and the effective rate of the patients in the experimental group was found to be significant,higher than the control group [RR(95%CI)=1.23(1.15-1.32), P<0.05]. The incidence of adverse reactions was reported in 9 articles. A total of 42 patients had adverse reactions, and the incidence of adverse reactions was 5.53%. Among them, 19 cases were chest tightness, bradycardia, fatigue,and 2 cases were worse in both lower extremity edema. 5 patients had second-degree atrioventricular block, accounting for 2.50%, 0.26%, and 0.66%,respectively. Because the effect amount was not statistically heterogeneous(c2=0.91, P>0.05), the fixed effect model was used in the meta-analysis,and the incidence of adverse reactions in the experimental group was significantly higher than that in the control group [RR(95%CI)=10.17(3.92-26.37), P<0.05]. Conclusion Metoprolol is effective in the treatment of elderly patients with chronic heart failure, but has more adverse reactions.