SS 31肽防治模型动物心力衰竭的疗效与安全性系统评价

摘要

目的：系统评价 SS 31肽防治模型动物心力衰竭的疗效及安全性。方法计算机检索 PubMed、Embase、OVID、CBM、CNKI、VIP及 WanFang Data等数据库,手动检索参考文献,纳入 SS 31肽防治心力衰竭的动物实验。结局评价包括心肌舒缩功能、血流动力学改变、BNP(或 NT proBNP)水平、心室重塑、氧化应激损伤、不良反应及不良事件。由两名研究者独立评价纳入研究的质量、提取数据并交叉核对,使用RevMan 5.2软件进行Meta分析。结果显示：3/49篇文献经剔重、初筛及全文复筛纳入。纳入研究中,3篇文献均报道了 SS 31肽对心衰模型动物心肌舒缩功能的影响,表明 SS 31肽对心衰模型动物左室舒张末内径、每搏输出量及射血分数的变化均具一定的良性干预作用。但基于2篇文献中左室短轴缩短率(LVFS)比较的Meta分析,结果提示SS 31肽对心衰模型动物 LVFS的改善无显著作用[SMD=7.18,95%CI (-1.91,16.26),P=0.12]。1篇文献报道表明 SS 31肽对心衰模型动物血流动力学相关病理改变无显著影响。2篇报道 SS 31肽干预心衰模型动物心室重塑疗效的研究结果存在异质性。3篇文献均报道了 SS 31肽治疗对心衰模型动物氧化应激损伤的改善作用,且均显示出确切的干预疗效。纳入研究均未报道 SS 31肽治疗对 BNP(或 NT proBNP)水平的影响,亦未见药物不良反应的相关报道。1篇文献报道了动物死亡事件的发生率,提示药物干预过程中无严重不良事件的发生。结论 SS 31肽对模型动物心力衰竭的防治具有潜在的疗效,但因证据单薄,目前尚无法得到较为可靠的结论。%Objective To assess the efficacy and safety of Szeto Schil er (SS) 31 peptide for heart failure based on animal models. Methods We searched PubMed,Embase,OVID,CBM,CNKI,VIP,WanFang Data,and references were hand searched. Al re-searches based on animal models of treating heart failure with SS 31 peptide versus sham groups were included. Outcome meas-urements included cardiac systolic and diastolic function,hemodynamic changes,B type natriuretic peptide (BNP)or N terminal B type natriuretic peptide precursor(NT proBNP)level,cardiac remodeling,oxidative stress injury,adverse effects and events. Data were extracted independently by two reviewers. Results Three of the 49 articles were included through eliminating duplica-tions,title/abstract screening and ful text review. Three articles which reported the curative effect of SS 31 peptide in improving cardiac systolic and diastolic function indicated the marked curative effect on left ventricular end diastolic diameter (LVEDD),stroke volume and ejection fraction,while the Meta analysis result of LVFS showed no statistical difference between the model group and SS 31 peptide treatment group [SMD=7.18,95% CI (-1.91,16.26),P=0.12]. One article reported no significant changes of hemodynamic findings after the intervention of SS 31. The outcomes existed heterogeneity between the 2 articles reported the effi-ciency of SS 31 peptide in al eviating cardiac fibrosis. Three articles reported the improvement of myocardial oxidative stress injury in animal models through the administration of SS 31 peptide. None of the included articles reported the level of BNP (or NT proB-NP)nor SS 31 peptide related adverse effect.Based on the report of animal deaths from 1 article,showed no severe adverse events hap-pened during the administration course.Conclusion SS 31 peptide shows potential efficiency on heart failure,but the evidence was limited at present to reach a reliable conclusion.