曲美他嗪治疗急性病毒性心肌炎疗效的荟萃分析  

Trimetazidine:a meta-analysis of randomized controlled trial to the patients with Viral Myocarditis

作　　者：于昆[1] 汪英男 任毅[3] 张喜文[1] 张学锋[1] 张红[4] 

机构地区：[1]南京医科大学附属淮安市第一人民医院心内科,江苏淮安223300 [2]乌兰察布市中心医院心内科,内蒙古乌兰察布012000 [3]南京医科大学附属淮安市第一人民医院甲乳外科,江苏淮安223300 [4]南京医科大学附属淮安市第一人民医院内分泌科,江苏淮安223300

出　　处：《中华医院感染学杂志》2014年第24期6139-6141,共3页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金资助项目(8200595)

摘　　要：目的评价曲美他嗪对成人急性病毒性心肌炎的疗效,并总结经验性治疗试验数据,为该药物临床应用范围扩展提供循证医学依据。方法收集自建库以来至2014年7月公开发表的与曲美他嗪治疗急性病毒性心肌炎相关的文章共14个文献总计962例患者;限定文献发表类型为随机对照临床试验,进行方法学质量评价并采用RevMan 5.1软件对纳入的试验结果进行荟萃分析。结果曲美他嗪与对照组比较,治疗总有效率升高19.96%;心肌酶转阴率升高23.89%;心律失常改善率升高42.40%;心电图ST-T异常改善率升高29.30%;心功能改善总体效应升高24.13%。结论常规治疗基础上加用曲美他嗪治疗病毒性心肌炎更有效,但仍需更多高质量的多中心随机对照试验验证。OBJECTIVE To evaluate the effect of trimetazidine on the patients with viral myocarditis .Data of empirical therapy were collected to contribute to the evidence‐based treatment .METHODS Relative articles on ran‐domized controlled trials （RCT ） of Trimetazidine for viral myocarditis in 14 literatures amounting 962 patients since the database built until July .2014 were collected .The type of the literature was confined as random com‐pared clinical experiment .The methodological quality evaluation and meta analysis were carried out with the assis‐tance of RevMan 5 .1 software to analyze the results brought into .RESULTS Compared with the control group , trimetazidine therapy was associated with a significant improvement both in the total effective rate （19 .96% ）and in the cardiac function（24 .13% ） .Meanwhile ,the trimetazidine group led to a better outcome than the control group in ameliorating the myocardial enzymogram （23 .89% ） and electrocardiogram abnormalities of cardiac arrhythmia （42 .40% ） and ST segment abnormal（29 .30% ） .CONCLUSION Trimetazidine might be an effective strategy for treating viral myocarditis .More studies ,especially larger multicentre RCT with high quality ,are urgently needed to clarify the mechanism and the long‐term effects of trimetazidine .

关 键 词：曲美他嗪 病毒性心肌炎 荟萃分析 

分 类 号：R542.21[医药卫生—心血管疾病]