厄贝沙坦联合胺碘酮与单用胺碘酮比较治疗阵发性房颤的Meta分析  

Irbesartan combined with Amiodarone versus Amiodarone alone for Paroxysmal Atrial Fibrillation: A Meta-analysis

作　　者：李艳君[1] 李乐[1] 唐艳红[1] 

机构地区：[1]武汉大学人民医院心血管内科,武汉430060

出　　处：《中国循证医学杂志》2015年第9期1078-1083,共6页Chinese Journal of Evidence-based Medicine

摘　　要：目的系统评价厄贝沙坦联合胺碘酮与单用胺碘酮比较治疗阵发性房颤中的效果。方法计算机检索Pub Med、CENTRAL、EMbase、VIP、CNKI和Wan Fang Data数据库,搜集厄贝沙坦联合胺碘酮与单用胺碘酮比较治疗阵发性房颤的相关随机对照试验(RCT),检索时限为2000年到2014年。由2位评价员独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用Rev Man 5.2软件进行Meta分析。结果共纳入9个RCT,998例患者。Meta分析结果显示:在治疗12个月后,厄贝沙坦联合胺碘酮组的左房内经明显小于单用胺碘酮组[MD=–1.49,95%CI(–1.82,–1.15),P<0.000 01],而窦性心律维持率明显高于单用胺碘酮组[OR=3.02,95%CI(2.21,4.11),P<0.000 01],且差异均有统计学意义。结论现有证据显示,厄贝沙坦联合胺碘酮治疗阵发性房颤,可延缓患者左心房内径扩大,维持窦性心率,疗效优于单用胺碘酮治疗。受纳入研究数量和质量所限,上述结论尚需开展更多高质量研究予以验证。Objective To systematically review the efficacy of irbesartan combined with amiodarone versus amiodarone alone for paroxysmal atrial fibrillation. Methods We electronically searched databases including PubMed, CENTRAL, EMbase, VIP, CNKI and WanFang Data to collect randomized controlled trials （RCTs） about irbesartan combined with amiodarone versus amiodarone alone in the treatment of paroxysmal atrial fibrillation from 2000 to 2014. Two reviewers independently screened literature, extracted data and assessed the risk bias of included studies. Then, meta- analysis was performed using RevMan 5.2 software. Results A total of nine studies involving 998 patients were included. The results of meta-analysis showed that： Compared with the amiodarone group, the left atrial diameter was smaller （MD= -1.49, 95% CI -1.82 to -1.15）, and the maintenance rates of sinus rhythm were higher （OR=3,02, 95%CI 2.21 to 4.11） in the irbesartan plus amiodarone group after 12 months. Conclusions Current evidence indicates that the combination treatment of irbesartan and amiodarone for paroxysmal atrial fibrillation is better than amiodarone alone in delaying the enlargement of left atrial diameter, as well as the maintenance of sinus rhythm, Due to limited quantity and quality of the included studies, more high quality studies are needed to verify the above conclusion.

关 键 词：厄贝沙坦 胺碘酮 阵发性房颤 系统评价 META分析 随机对照试验 

分 类 号：R541.75[医药卫生—心血管疾病]