心脉隆注射液治疗慢性心力衰竭临床疗效的 Meta 分析

摘要

目的：评价心脉隆注射液治疗慢性心力衰竭的临床疗效和安全性。方法计算机检索中国知网（CNKI）、中国生物医学文献光盘数据库（CBMdisk）、维普中文科技期刊数据库（VIP）、PubMed 及 Cochrane library 有关常规治疗基础上加用心脉隆注射液治疗慢性心力衰竭的研究。采用 RevMan 5,2,4软件对各项研究的 B 型脑钠肽（BNP）水平、心脏超声指标〔左心室射血分数（ LVEF）、左心室收缩末期内径（ LVESD）、左心室舒张末期内径（LVEDD）〕、6 min 步行距离（6- MWD）、中心静脉压（CVP）、临床疗效等进行分析。结果共纳入8个随机对照试验，共计866例心力衰竭患者，文献质量偏低。Meta 分析显示，在心力衰竭患者常规治疗的基础上加入心脉隆注射液后，能够进一步降低 BNP 水平〔加权均数差（WMD）=87,46，95% CI（74,90，100,03）〕和 CVP〔 WMD =0,78，95% CI（0,33，1,24）〕，增加 LVEF〔 WMD =6,58，95% CI（4,89，8,27）〕和6- MWD〔 WMD =52,86，95% CI （38,04，67,68）〕，提高临床疗效〔OR =3,00，95% CI（1,79，5,02）〕，还能改善远期复合终点和血清尿酸水平（ P<0,05）。个别心脉隆注射液所产生的不良反应，患者均能耐受。结论在常规治疗基础上加用心脉隆注射液治疗慢性心力衰竭安全、可靠，应该推广其临床使用范围。%Objective To evaluate the clinical efficacy and safety of Xinmailong injection in the treatment of chronic heart failure, Methods We searched in the CNKI,CBMdisk,VIP,PubMed and Cochrane library to identify studies on the clinical efficacy and safety of Xinmailong injection in the treatment of chronic heart failure based on conventional therapy, The BNP level,heart ultrasonic parameters〔left ventricular ejection fraction(LVEF),left ventricular end systolic diameter(LVESD), left ventricular end diastolic diameter(LVEDD)〕,6 min walking distance(6 - MWD),central venous pressure(CVP)and clinical efficacy of studies were analyzed by the RevMan 5, 2, 4 software, Results A total of 8 randomized controlled trials were reviewed,and 866 patients were included,the literature quality was relative low, Meta analysis result showed that:for patients with heart failure who received Xinmailong injection treatment on the basis of conventional therapy,BNP level〔WMD = 87, 46, 95% CI(74, 90,100, 03)〕and CVP〔 WMD = 0, 78,95% CI(0, 33,1, 24)〕decreased significantly,LVEF〔 WMD =6, 58,95% CI(4, 89,8, 27)〕and 6 - MWD increased significantly〔WMD = 52, 86,95% CI(38, 04,67, 68)〕,thus clin-ical efficacy improved significantly〔OR = 3, 00,95% CI(1, 79,5, 02)〕,both the long - term composite endpoint of heart failure and serum uric acid levels improved significantly( P < 0, 05), In addition,the patients can tolerate adverse reaction which caused by Xinmailong injection, Conclusion The use of the Xinmailong injection in the treatment of chronic heart failure based on conventional therapy is safe and reliable,it is worth further clinical application and spread.