雷诺嗪对心房颤动的治疗或预防作用及其安全性的Meta分析  

Efficacy and safety of Ranolazine for the prevention or treatment of atrial fibrillation：a meta-analysis

作　　者：赵红宜 赵庆彦[1] 代子玄[1] 张淑娟[1] 

机构地区：[1]武汉大学人民医院心内科 武汉大学心血管病研究所 心血管病湖北省重点实验室,湖北省武汉市430060

出　　处：《中国心血管病研究》2016年第10期932-935,共4页Chinese Journal of Cardiovascular Research

摘　　要：目的 系统评价雷诺嗪对心房颤动的治疗或预防作用及其安全性.方法 计算机检索中国知网数据库、中国生物医学文献数据库、万方数据库、维普数据库（VIP）、中国期刊全文数据库及PubMed数据库、Embase、ScienceDirect、Cochrane图书馆临床对照试验中心资料数据库（文献年份不限）,收集比较雷诺嗪与其他药物治疗或预防患者心房颤动发生的随机对照研究或非随机对照研究.由2名评价者按纳入、排除标准选择、提取资料,并交叉对比、评估文献质量,使用Revman 5.2软件进行Meta分析.结果 共纳入7项研究7396例患者.①单用雷诺嗪或联用抗心律失常药物在预防房颤发生/复发方面优于对照组（OR=0.52,95％CI 0.41～0.65,P＜0.01）;对于研究起点有房颤的患者,单用雷诺嗪或联用抗心律失常药物在预防房颤发生方面疗效优于对照组（OR =0.33,95％CI 0.22～0.50,P＜0.01）;对于研究起点无房颤的患者,单用雷诺嗪或联用抗心律失常药物在预防房颤发生方面疗效优于对照组（OR =0.60,95％CI 0.39～0.92,P＜0.05）.②致低血压率：与对照组相比,单用雷诺嗪或联用其他药物低血压发生率明显增加（OR=1.77,95％CI 1.13～2.79,P＜0.05）.QTc间期延长：与对照组相比,单用雷诺嗪或联用其他药物明显延长QTc间期（OR =3.57,95％CI 0.74～6.40,P＜0.05）.结论 雷诺嗪在治疗心房颤动方面具有较好的疗效,但不良反应率较高.Objective To evaluate the efficacy of Ranolazine for the prevention or treatment and the safety of atrial fibrillation. Methods We performed a literature search in CNKI database, Chinese biomedical literature database, Wanfang database, VIP database（VIP）, China Journal Full-text Database and PubMed, EMBASE, ScieneeDirect, Coehrane Library control test center database, collecting and comparing ranolazine and other antiarrhythmia agents in patients with atrial fibrillation. According to the inclusion and exclusion criteria, exclusive choice and extraction of data, and cross correlation, evaluation of quality and methodology, using Revman 5.2 software to perform the recta-analysis. Results 7 studies of 7396 cases were included. （1）Single use of Ranolazine or combined with antiarrhythmic drugs in preventing the occurrence or recurrence of atrial fibrillation is better than the control group （OR=0.33, 95%C1 0.22-0.50, P〈0.O1 ）. For the starting point with atrial fibrillation patients, single use of Ranolazine or combined with antiarrhythmic drugs in the prevention of atrial fibrillation occurred effect is better than that of control group （OR=0.33, 95%CI 0.22-0.50, P〈0.01）. For the starting point without atrial fibrillation patients, single use of Ranolazine or combined with antiarrhythmic drugs in the prevention of atrial fibrillation occurred effect is better than that of control group（OR=0.60, 95%CI 0.39-0.92, P〈0.05 ）. （2）Incidence of hypotension： single use of Ranolazine or combined with antiarrhythmic drugs significantly increased the incidence of hypotension compared with control groups （OR=1.77, 95%CI 1.13-2.79, P〈0.05）, single use of Ranolazine or combined with antiarrhythmic drugs significantly increased the QTc interval compared with control groups （OR =3.57, 95%CI 0.74-6.40, P〈0.05）. Conclusion Ranolazine has better treatment or prevention effect on atrial fibrillation, but the adverse reaction rate is higher.

关 键 词：雷诺嗪 心房颤动 荟萃分析 

分 类 号：R541.7[医药卫生—心血管疾病]