重组人脑利钠肽治疗急性心力衰竭疗效和安全性的Meta分析

The efficacy and safty of recombinant human brain natriuetic peptide for the treatment of acute heart failure: a meta analysis

目的系统评价重组人脑利钠肽(rh BNP)治疗急性心力衰竭的疗效和安全性。方法通过Medline、Pubmed、CNKI、维普数据库检索有关重组人脑利钠肽治疗急性心力衰竭的文献,采用Jadad量表进行质量评分,用Rev Man5.0软件进行统计分析。结果纳入24篇随机对照试验,Meta分析结果显示:重组人脑利钠肽治疗组的呼吸困难症状改善情况优于对照组[RR=1.04,95%CI(1.01,1.07),P<0.05],重组人脑利钠肽治疗组的尿量增加情况优于对照组[MD=467.21,95%CI(288.08,646.34),P<0.01],重组人脑利钠肽治疗组的再住院率与对照组比较无差异[RR=0.93,95%CI(0.80,1.10),P=0.41],重组人脑利钠肽治疗组的死亡率低于对照组[RR=0.74,95%CI(0.65,0.83),P<0.05]。结论重组人脑利钠肽可明显改善呼吸困难症状、增加尿量、降低死亡率,对再住院率无影响。

Objective To evaluate the therapeutic effect and safety of rhBNP for acute heart failure. Methods Infor-mation on the therapeutic effect and safety of rhBNP for acute heart failure were reviewed from Medline,Pubmed,CNKI and VIP. All reviewed literatures were accessed by Jadad quality scale. Statistic data was analysed by RevMan5.0. Results 24 articles of randomized controlled trial were collected. The Meta-analysis showed: the improvement of dyspnea in the rhBNP group was more significant than the control group[RR=1.04,95%CI(1.01,1.07),P<0.05], the increase of urine output in the rhBNP group was more significant than the control group [MD=467.21,95%CI(288.08,646.34),P<0.01], there was no difference in the rate of rehospitalization between the rhBNP group and the control group [RR=0.93,95%CI (0.80,1.10),P=0.41], the death rate in the rhBNP group was lower than the control group[RR=0.74,95%CI(0.65,0.83),P<0.05]. Conclusion RhBNP can obviously im-prove the symptoms of dyspnea,increase urine output,decrease death rate. The rate of rehospitalization is not affected by rhBNP.