摘要
目的系统评价国内外尼可地尔治疗急慢性心力衰竭(心衰)患者的有效性及安全性。方法计算机检索PubMed、EMbase、ISI Web of Science、The Cochrane Library、CNKI、万方等数据库,检索时限为从建库至2019年12月,收集所有有关尼可地尔治疗心力衰竭患者的有效性及安全性的随机对照试验。对纳入研究的质量进行严格评价和资料提取,对符合标准的文献进行Meta分析。结果共纳入23项研究包括1863例患者,其中实验组为在常规治疗基础上加用尼可地尔,共936例,对照组为常规治疗或在常规治疗基础上加用安慰剂、硝酸甘油或卡培立肽,共927例。Meta分析显示:与对照组相比,尼可地尔能够降低全因死亡率和心衰再住院率(OR=0.43,95%CI:0.24~0.78,P=0.006),改善患者心功能(OR=3.67,95%CI:1.92~7.05,P<0.001),并能显著提高6分钟步行距离(6MWD,MD=49.59,95%CI:36.94~62.23,P<0.001),减轻呼吸困难症状(MD=0.55,95%CI:0.33~0.77,P<0.001),且不会增加心衰患者不良反应发生率(OR=0.65,95%CI:0.26~1.61,P=0.35)。结论尼可地尔对于心衰具有显著的疗效,且未增加不良反应发生率。
Objective To review systematically the efficacy and safety of nicorandil in treatment of acute or chronic heart failure(HF)at home and abroad.Methods The databases of PubMed,EMbase,ISI Web of Science,Cochrane Library,CNKI and WanFang Data were retrieved with computer for collecting the randomized controlled trials(RCT)about the efficacy and safety of nicorandil in HF treatment from database establishment time to Dec.2019.The quality of included RCT was reviewed and data was extracted strictly,and eligible documents were given a Meta-analysis.Results There were totally 23 RCT included involved 1863 patients.The test group(n=936)was treated with nicorandil besides of routine treatment,and control group(n=927)were treated with placebo,nitroglycerin or carperitide besides of routine treatment.The results of Meta-analysis showed that nicorandil decreased all-cause mortality and rehospitalization due to HF(OR=0.43,95%CI:0.24~0.78,P=0.006),improved heart function(OR=3.67,95%CI:1.92~7.05,P<0.001),increased significantly 6-minute walk distance(MD=49.59,95%CI:36.94~62.23,P<0.001)and relieved dyspnea symptoms(MD=0.55,95%CI:0.33~0.77,P<0.001),and did not increased incident rate of adverse reaction(OR=0.65,95%CI:0.26~1.61,P=0.35)in HF patients.Conclusion Nicorandil has significant curative effect on HF and cannot promote incident rate of adverse reaction.
作者
李本磊
熊晓昉
祝芬
李俊
周丽琴
Li Benlei;Xiong Xiaofang;Zhu Fen;Li Jun;Zhou Liqin(Department of Cardiology,Third Hospital of Wuhan City,Wuhan 430060,China;不详)
出处
《中国循证心血管医学杂志》
2020年第12期1425-1431,1438,共8页
Chinese Journal of Evidence-Based Cardiovascular Medicine
基金
武汉市卫生计生科研基金资助(WX17C24)。
