左西孟旦注射液治疗老年心力衰竭有效性和安全性的系统评价  

Efficacy and safety of Levosimendn in the treatment of heart failure in the elderly:a Meta-analysis

作　　者：朱瑛[1] 赵澐[1] 

机构地区：[1]复旦大学附属华东医院急诊科,上海市200040

出　　处：《老年医学与保健》2016年第6期370-374,共5页Geriatrics & Health Care

摘　　要：目的评价左西孟旦注射液治疗老年心力衰竭有效性和安全性。方法计算机检索PubMed、Web ofScience、OVID、Cochrane Library、中国知网、万方数据库和维普数据库等有关左西孟旦治疗老年心力衰竭的随机对试验RCT,检索时间为建库至2015年12月31日,对每个纳入研究进行偏倚风险和质量评估,统计学分析予RevMan 5.3软件进行Meta分析。结果共纳入11篇RCT文献。Meta分析结果显示:有效性方面:评估心力衰竭疗效总体有效率差异有统计学意义[0R=5.10,95%CI=(2.98,8.72),P<0.00001];治疗后两组LVEF差异有统计学意义[MD=5.16,95%CI=(4.48,5.85),P<0.00001];安全性方面:两组所致的不良反应差异无统计学意义[OR=1.48,95%CI=(0.66,3.32),P=0.34]。结论左西孟旦治疗老年心力衰竭疗效优于常规抗心衰药物,提高LVEF值,但两者在不良反应方面无统计学差异。Objective To evaluate the efficacy and safety of levosimendan in the treatment of heart failure in the elderly. Methods The databases, including PubMed, Web of Science, OVID, Cochrane Library, CNKI, Wangfang and Weipu, were retrieved to collect the randomized controlled trials （RCT） about levosimendan in the treatment of heart failure in the elderly from the date of establishment of the databases to December, 2015; after the critical evaluation on the quality of literature, the extracted data were analyzed by RevMan5.3 software. Results 11 studies met the inclusion criterion; Metaanalysis showed that there existed differences of statistical significance between the 2 groups in evaluating the total effective rate [OR=5.10, 95%CI= （2.98,8.72）, P〈0.00001]; LVEF in levosimendan group increased after the treatment, and the difference in LVEF between the 2 groups was of statistical significance [MD =5.16, 95 %CI= （4.48,5.85）, P〈0.00001]; no difference of statistical significance in the occurrence of side effects was found between the 2 groups [OR= 1.48,95% CI= （0.66,3.32）, P=0.34]. Conclusions Levosimendn is superior to routine anti-heart failure drugs in the treatment of heart failure in the elderly; it can improve LVEF without increasing the side effects.

关 键 词：老年 左西孟旦 心力衰竭 随机对照试验 META分析 

分 类 号：R541.6[医药卫生—心血管疾病]