曲美他嗪治疗慢性心力衰竭随机对照研究的Meta分析
Efficacy of Trimetazidine in Chronic Heart Failure: A Meta-Analysis of Randomized Controlled Trials
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摘要: 目的 评价曲美他嗪在慢性心力衰竭患者中的应用价值。 方法 应用Cochrane系统评价方法,检索1990年至2010年9月Cochrane 图书馆临床对照试验资料库、PubMed、EMBASE数据库,应用RevMan 5.0进行数据Meta分析,选择随机效应模型评价曲美他嗪对慢性心力衰竭的治疗效果。 结果 共检索到122篇相关文献,经过评价,9个临床试验符合本设计的标准而入选。Meta分析显示,曲美他嗪联合常规抗心力衰竭治疗能够显著提高慢性心力衰竭患者的左心室射血分数标准化均数差1.21,95%可信区间（0.99,1.42）,P=0.000,可以显著减少左心室收缩末容积标准化均数差-0.28,95%可信区间（-0.48,-0.07）,P=0.008和左心室舒张末容积标准化均数差-0.72,95%可信区间（-0.96,-0.48）,P=0.000。 结论 曲美他嗪对慢性心力衰竭的治疗具有积极的临床意义,与传统的抗心力衰竭药物联合应用,仍能够显示益处,临床受益与原发疾病无关。Abstract: Objective To evaluate the efficacy of Trimetazidine in combination with other traditional treatment agents in chronic heart failure patients. Methods We searched the Cochrane Central Register of Controlled Trials, PubMed, EMBASE, and identified randomized controlled trials on the effect of Trimetazidine in patients with chronic heart failure. Results Nine clinical trials meeting our criteria were identified and extracted. Results showed that Trimetazidine significantly reduced the LVEDV 95%CI（-0.48, -0.07）, P=0.008 and LVESV 95%CI（-0.96, -0.48）, P=0.000, and improve LVEF 95%CI（0.99, 1.42）, P=0.000 in chronic heart failure patients. Conclusion The efficacy of Trimetazidine in the treatment of chronic heart failure was confirmed when used with conventional agents, in ischemic or non-ischemic cardiomyopathy.
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