环磷酸腺苷葡甲胺治疗病态窦房结综合征疗效Meta分析

摘要

Objective To systematic evaluate the therapeutic effect of meglumine adenosine cyclophosphate for treat-ment of patients with sick sinus syndrome. Methods Computer retrieval PubMed, CENTRAL, EMbase, the ISI Web of Knowledge Databases,VIP,CNKI,CBM and Wanfang database to collect the randomized controlled trials of meglumine adeno-sine cyclophosphate for treatment of sick sinus syndrome, data were collected from 1999 January to 2013 December. According to the inclusion and exclusion criteria, extraction and quality evaluation of screening RCT data were performed by 2 observer independently;statistical analysis was performed using RevMan5. 2 software. Results 13 study of 1 119 patients were included, the Meta-analysis results showed that:compared with the control group, meglumine cyclic adenosine for sick sinus syndrome can improve the total efficiency (OR=7. 29, 95%CI 5. 42-9. 81, P <0. 01), increased the 24 h’s total heart rate (SMD=4.74,95%CI4.42-5.06,P <0.01) andtheaverageheartrate(MD=11.56,95%CI10.79 -12.33,P <0.01), shorten the sinus node recovery time (SNRT) (SMD= -1. 49, 95%CI -1. 65 to -1. 33, P <0. 01) and sinoatrial conduc-tion time (SACT) (MD= -85. 39, 95%CI -90. 22 to -80. 56, P <0. 01). Conclusion Meglumine cyclic adenosine in treating of sick sinus syndrome can significantly improve the clinical symptoms and cardiac function as increase the 24 h’ s to-tal heart rate and average heart rate, shorten the sinus node recovery time and sinoatrial conduction time.%目的：系统评价环磷酸腺苷葡甲胺治疗病态窦房结综合征患者的疗效。方法计算机检索PubMed、CENTRAL、EMbase、the ISI Web of Knowledge Databases、VIP、CNKI、CBM和万方数据库,收集关于环磷酸腺苷葡甲胺治疗病态窦房结综合征的随机对照试验的文献,检索时限均为1999年1月—2013年12月。按纳入排除标准由2人独立进行RCT的筛选、资料的提取和质量评价以后,采用RevMan5.2软件进行统计学分析。结果共纳入13个研究、1119例患者,Meta分析结果显示：与对照组比较,环磷酸腺苷葡甲胺治疗病态窦房结综合征患者可提高总有效率(OR=7.29,95%CI 5.42~9.81, P <0.01),增加24 h总心率(SMD=4.74,95%CI 4.42~5.06, P <0.01)及平均心率(MD=11.56,95%CI 10.79~12.33, P <0.01),缩短窦房结恢复时间(SNRT)(SMD=-1.49,95%CI -1.65~-1.33, P <0.01)和窦房结传导时间(SACT)(MD=-85.39,95%CI -90.22~-80.56, P <0.01)。结论环磷酸腺苷葡甲胺治疗病态窦房结综合征可明显改善患者的临床症状及心脏功能,主要表现为增加24 h总心率及平均心率,缩短窦房结恢复时间和窦房结传导时间。