1,6-二磷酸果糖联合西药改善慢性心力衰竭患者心功能的meta分析和GRADE质量评价

Meta analysis and GRADE quality evaluation of 1, 6-diphosphate fructose combined with western medicine in improving cardiac function of patients with chronic heart failure

目的 系统评价1,6-二磷酸果糖联合西药改善慢性心力衰竭(CHF)患者心功能的效果及证据级别。方法 检索中国知网、万方数据库、维普网、中国生物医学文献服务系统、Pub Med、Web of Science建库至2022年11月有关1,6-二磷酸果糖用于治疗CHF患者的随机对照研究。利用Endnote 20.0、Review Manager 5.4.1、GRADE profiler进行文献管理、meta分析和结局指标的证据质量评价。结果 共纳入9篇文献,涉及771例观察对象,其中试验组388例,对照组383例。meta分析结果显示,试验组左室射血分数(MD=5.00,95%CI:4.91~5.09,P=0.000 01)、E/A(MD=0.10,95%CI:0.04~0.16,P=0.000 08)、心排血指数(MD=0.61,95%CI:0.38~0.83,P=0.00001)、心排血量(MD=0.73,95%CI:0.36~1.10,P=0.0001)高于对照组。GRADE质量评价提示纳入文献证据级别为低级。结论 1,6-二磷酸果糖联合西药可改善CHF患者心功能,但仍需高级别证据支持。

Objective To systematically evaluate the effect and evidence level of 1,6-diphosphate fructose combined with western medicine on improving cardiac function in patients with chronic heart failure(CHF).Methods Randomized controlled trials on the use of 1,6-diphosphate fructose in treating patients with CHF were searched through CNKI,Wanfang Data,VIP,China Biomedical Literature Service System,PubMed,and Web of Science from inception to November 2022.Literatures management,meta analysis,and outcome indicators were evaluated by Endnote 20.0,Review Manager 5.4.1,and GRADE profiler.Results A total of nine literatures were included,involving 771 subjects,including 388 in the experimental group and 383 in the control group.The results of meta analysis showed that left ventricular ejection fraction[MD=5.00,95%CI:4.91-5.09,P=0.00001],E/A[MD=0.10,95%CI:0.04-0.16,P=0.00008],cardiac output index[MD=0.61,95%CI:0.38-0.83),P=0.00001],cardiac output[MD=0.73,95%CI:0.36-1.10,P=0.0001]of experimental group were higher than those of control group.GRADE quality evaluation suggested that the evidence levels of the included literatures were low.Conclusion 1,6-diphosphate fructose combined with western drugs can improve cardiac function in patients with CHF,but high-level evidence is still needed.