间断静脉内注入左西孟旦对失代偿性心力衰竭疗效的Meta分析

    Efficacy of Intermittently Intravenous Levosimendan Infusion on Decompensated Heart Failure: A Meta-Analysis

    • 摘要: 目的 探讨间断静脉内注入左西孟旦对失代偿性心力衰竭的疗效。 方法 应用计算机从PubMed、Cochrane 图书馆、Elsevier、Wiley、Web of Science、CNKI、万方数据库等电子数据库中检索自建库至2015 年1 月以来关于间断静脉内注入左西孟旦治疗失代偿性心力衰竭的随机对照试验。获取数据资料后进行Meta分析,研究间断静脉内注入左西孟旦治疗失代偿性心力衰竭的长期疗效。 结果 对纳入的8个随机对照试验进行Meta分析,随访末各项指标与基础值比较,左西孟旦注入组左心室射血分数明显增加(加权均数差=4.27%,95%可信区间2.51%~6.04%),差异有统计学意义(P<0.000 01);短期和中期病死率明显减少(相对危险度=0.37,95%可信区间0.25~0.45),差异有统计学意义(P<0.000 01);脑钠肽及纽约心脏病心功能分级与对照组比较差异无统计学意义。 结论 间断静脉内注入左西孟旦能够改善血流动力学参数,降低短期和中期病死率。

       

      Abstract: Objective To discuss the efficacy of intermittently intravenous Levosimendan infusion on decompensated heart failure(DHF). Methods The databases of PubMed,Cochrane Library, Elsevier, Wiley, Web of Science, CNKI, Wanfang database and VIP database were retrieved by using computer for collecting the randomized controlled trials (RCT) until January in 2015 about the treatment of DHF with intermittently intravenous Levosimendan infusion. The long-term efficacy of intermittently intravenous Levosimendan infusion on heart function after DHF was studied through a meta-analysis on extracted data. Results A meta-analysis was conducted in the included 8 RCT, the comparison in all indexes and base values showed that left ventricular ejection fraction (LVEF) increased significantly (WMD=4.27%, 95%CI 2.51%~6.04%) in Levosimendan group, and had statistical difference(P<0.000 01). Short-term and mid-term mortality rate reduced significantly (RR=0.37, 95%CI 0.25~0.45) compared to control group. Level of brain natriuretic peptide (BNP) and New York heart association (NYHA) class function had no statistical significance compared with control group. Conclusions Intermittently intravenous Levosimendan infusion can ameliorate hemodynamic parameters and reduce short-term and mid-term mortality rate.

       

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