减重代谢手术对肥胖患者心衰影响的系统评价和Meta分析

A Systematic Review and Meta-Analysis of Weight Loss Metabolic Surgery on Heart Failure in Obese Patients

目的探讨减重代谢手术预防肥胖患者发生心衰的效果。方法计算机检索医学文献数据库相关文献,行质量评价并提取数据,采用Rev Man 5.3软件对数据进行Meta分析。结果共纳入13篇文献311170例患者。无心衰病史的肥胖患者减重代谢手术后心衰发生率低于对照组,差异有统计学意义[RR=0.35,95%CI(0.16,0.78),P=0.01];有心衰病史的肥胖患者在减重代谢手术后因心衰住院率低于对照组,差异无统计学意义[RR=0.76,95%CI(0.36,1.6),P=0.48];减重手术组心衰患者死亡率低于对照组,差异有统计学意义[RR=0.49,95%CI(0.41,0.58),P<0.00001]。结论减重代谢手术可预防肥胖患者心衰的发生,降低肥胖患者因心衰导致的死亡率,但需要高质量的前瞻性研究来验证。

Objective To investigate the effect of weight loss metabolic surgery in preventing heart failure for obese patients.Methods The relevant documents of medical literature database were retrieved by computer to perform quality evaluation and extract data.The Rev Man 5.3 software was used to merge extracted information with Meta.Results A total of 13 articles were included with 311170 patients.The incidence of heart failure in obese patients without a history of heart failure after weight loss metabolic surgery was lower than that of control group with statistically significant difference[RR=0.35,95%CI(0.16,0.78),P=0.01].The hospitalization rate of obese patients with a history of heart failure due to heart failure after weight loss metabolic surgery was lower than that of control group without statistically significant difference[RR=0.76,95%CI(0.36,1.6),P=0.48].The mortality rate of heart failure patients in weight loss metabolic surgery group was lower than that of control group with statistically significant difference[RR=0.49,95%CI(0.41,0.58),P<0.001].Conclusion Weight loss metabolic surgery could prevent heart failure occurrence in obese patients and reduce obese patients’mortality due to heart failure,but it is need to verify by high-quality prospective studies.