摘要
目的:应用Meta分析系统评价β受体阻滞剂/地尔硫对扩张型心肌病(DCM)患者病死率的影响。方法:在PubMed、Elsevier、万方、知网数据库检索截止到2016-11-30有关β受体阻滞剂/地尔硫治疗DCM患者病死率评价的临床研究(RCT或高质量前瞻性队列研究),按照Cochrance handbook提供的方法对纳入的RCT文献进行质量评估,前瞻性队列研究采取Newcastle-Ottawa Scale(NOS)评分进行质量评估,并提取相关数据,应用RevMan 5.3软件进行统计分析。结果:纳入7篇研究,共包含1 024例研究对象,其中4篇有关β受体阻滞剂,3篇有关地尔硫。试验组共521例,对照组503例。平均随访时间7.4~36.0个月。汇总结果提示与对照组相比,β受体阻滞剂可降低全因死亡率[风险比(RR)=0.61,95%可信区间(CI):0.43~0.85];同样地尔硫也可降低全因死亡率(RR=0.42,95%CI:0.24~0.74)。结论:Meta分析结果提示β受体阻滞剂和地尔硫均可降低DCM患者的全因死亡率,获益可能与药物抑制抗心肌抗体引起心肌细胞损伤和室性心律失常有关。
Objective：The purpose of this meta-analysis was to evaluate the efficacy of Beta-blockers/diltiazem on mortality in patients with dilated cardiomyopathy.Method：We searched in PubMed,Elsevier,WanFang and CNKI database,and found the randomized control trials or high quality prospective cohort studies about efficacy of Beta-blockers/diltiazem on mortality in patients with dilated cardiomyopathy.The quality of randomized control trials were assessed according to the method provided by the Cochrane Handbook.Newcastle-OttawaScale（NOS）score was evaluated in the quality of prospective cohort studies.Data were extracted and analyzed by using the Software RevMan 5.3.Result：In the 7studies,4of them were Beta-Blockers studies and 3were diltiazem researches.A total of 1 024 subjects,521of them were in the experimental group and 503 in the control group.The mean follow-up times were from 7.4months to 36 months.Compared with placebo,Beta-blockers significantly reduced all cause mortality[random effect odds ratio（RR）=0.61,95%confidence interval（CI）：0.43 to 0.85]and diltiazem significantly reduced all cause mortality（RR=0.42,95%CI：0.24 to 0.74）.Conclusion：Meta-analysis suggests that Beta blockers and diltiazem can reduce all-cause mortality in patients with dilated cardiomyopathy,because they inhibit myocardial injury and ventricular arrhythmia caused by anti myocardial antibody.
作者
魏晶晶
袁璟
汪朝晖
廖玉华
WEI Jingjing YUAN Jing WANG Zhaohui LIAO Yuhua(Key Laboratory of Biological Targeted Therapy of the Ministry of Education, Institute of Car diology, Union Hospital, Tongji Medical College, Huazhong University of Science and Tech nology, Wuhan,430022, Chin)
出处
《临床心血管病杂志》
CAS
CSCD
北大核心
2017年第2期128-132,共5页
Journal of Clinical Cardiology
关键词
Β受体阻滞剂
地尔硫
抗心肌抗体
扩张型心肌病
adrenergic beta-antagonists
diltiazem
anti myocardial antibody
dilated cardiomyopathy
