胺碘酮联合美托洛尔治疗心肌梗死合并快速心律失常患者疗效的META分析

META-Analysis of Efficacy of the Amiodarone Combined with Metoprolol in Patients with Myocardial Infarction Complicated with Tachyarrhythmia

目的:探讨胺碘酮联合美托洛尔对心肌梗死合并心律失常患者的效果。方法:检索EMbase、PubMed、知网、万方、Web of Science、维普、全球学术快报等数据库中从2015年始至2021年发表的文章,包括中文和英文。结果:最终纳入12篇文献RCTs进行META分析。与单用胺碘酮组比较,胺碘酮联合美托洛尔治疗MI合并快速心律失常可以增加MI患者转复快速心律失常的有效率(RR = 1.20,95%CI = 1.14~1.27,P = 0.00);以及改善心功能LVESD (WMD = −7.59,95%CI = −8.55~−6.63,P = 0.00);CO (WMD = 1.17,95%CI = 1.08~1.25,P = 0.00)而对LVEF (WMD = 9.60,95%CI = 7.93~11.27,P = 0.00);LVEDD (WMD = −11.39,95%CI = −12.85~−9.92,P = 0.00)影响不大。结论:胺碘酮联合美托洛尔治疗MI合并快速心律失常患者可改善患者心功能,疗效显著,有助于患者的预后。

Objective: To investigate the effect of amiodarone combined with metoprolol on patients with myocardial infarction complicated with arrhythmia. Methods: Literature published since 2015, including Chinese and English, were searched in EMbase PubMed, ZhiWang, Wanfang, Web of Science, VIP, Global Academic Express and other databases. Results: 12 literatures of RCTs were finally included for META analysis. Compared with the amiodarone alone group, amiodarone combined with metoprolol in the treatment of MI combined with tachyarrhythmia can increase the effective rate of MI patients to convert to tachyarrhythmia (RR = 1.20, 95%CI = 1.14~1.27, P = 0.00);and to improve cardiac function of LVESD (WMD = −7.59, 95%CI = −8.55~−6.63, P = 0.00);CO (WMD = 1.17, 95%CI = 1.08~1.25, P = 0.00), but has little effect on LVEF (WMD = 9.60, 95%CI = 7.93~11.27, P = 0.00);LVEDD (WMD = −11.39, 95%CI = −12.85~−9.92, P = 0.00). Conclusion: Amiodarone combined with metoprolol can improve the cardiac function of patients with MI complicated with tachyarrhythmia.