曲美他嗪治疗扩张型心肌病心力衰竭临床效果的meta分析

摘要

目的：系统性评价曲美他嗪治疗扩张型心肌病心力衰竭（心衰)的临床效果。方法检索中国知网、中国生物医学文献数据库、维普数据库、万方数据库、PubMed、Cochrane图书馆、Embase 1990年1月—2014年10月关于曲美他嗪治疗扩张型心肌病的随机对照试验（ randomized controlled trials, RCT),同时筛检纳入文献的参考文献,并对文献质量进行严格评价和资料提取,对符合质量标准的研究进行meta分析。结果本研究纳入RCT文献14篇共791例,文献质量评价结果A级1篇,B级13篇。曲美他嗪组临床有效性和心功能（左心室射血分数和左心室舒张末期内径)改善情况均优于对照组,差异有统计学意义（ OR =4．18；95%CI 2．5,6．36；P <0．01。 MD =8．05；95%CI 7．49,8．60；P<0．01。 MD=-2．84；95%CI-3．76,-1．19；P<0．01)。结论曲美他嗪可以明显改善扩张型心肌病心衰患者的临床症状,提高治疗效果。%Objective To review the efficacy of Trimetazidine for dilated cardiomyopathy associated with chronic con-gestive heart failure. Methods The documents of randomized controlled trials( RCT) related to the efficacy of Trimetazidine for dilated cardiomyopathy associated with chronic congestive heart failure were retrieved from the databases of CNKI, CBM, VIP, PubMed(1990. 10 ~2014. 10), Cochrane, EMbase(1990. 10 ~2014. 10) and the references of these RCT were re-trieved by hand at the same time. The documents were screened,extracted and evaluated according to inclusion and exclusion criteria,and then given a meta-analysis, using Rev Man 5. 1 software. Results There were totally 14 RCTs (1704 patients) included. The results of meta-analysis were as follows: Trimetazidine could improve the clinical effective rates and cardiac function(OR=4. 18, 95%CI 2. 5~6. 36,P<0. 01. MD=8. 05, 95%CI 7. 49~8. 60, P<0. 01. MD= -2. 84, 95%CI-3. 76~ -1. 19, P<0. 01). Conclusion Trimetazidine can improve efficacy of Trimetazidine for dilated cardiomyopathy associated with chronic congestive heart failure.