缬沙坦与依那普利分别治疗慢性心力衰竭的系统评价  

Meta-analysis on Efficacy of Valsartan and Enalapril in Treatment of Chronic Heart Failure

作　　者：冯名海 储文功[2] 董胜利[1] 

机构地区：[1]解放军第181医院一五八临床部,广西柳州545006 [2]第二军医大学药学院,上海200433

出　　处：《中国医院用药评价与分析》2017年第10期1379-1383,共5页Evaluation and Analysis of Drug-use in Hospitals of China

摘　　要：目的:系统评价缬沙坦与依那普利分别治疗慢性心力衰竭的临床疗效和安全性,为临床用药提供参考。方法:计算机检索Embase、Pub Med、Cochrane library、生物医学文献、中国学术期刊全文数据库、维普数据库及万方数据库等数据库,收集缬沙坦与依那普利分别治疗慢性心力衰竭的随机对照试验,采用Rev Man 5.3软件进行文献荟萃(Meta)分析。结果:最终入选14篇文献,共1 665例慢性心力衰竭患者。Meta分析结果显示,在总有效病例数、左心室射血分数、左心室舒张末期内径或容积和左心室收缩末期内径或容积变化情况方面,缬沙坦组与依那普利组的差异均无统计学意义(P>0.05);缬沙坦组患者的不良反应发生率明显低于依那普利组,差异有统计学意义(RR=0.45,95%CI=0.31~0.66,P<0.01)。结论:当前证据显示,缬沙坦治疗慢性心力衰竭的疗效与依那普利相当,但其安全性优于依那普利。OBJECTIVE：To systematically review the clinical safety and efficacy of valsartan and enalapril in treatment of chronic heart failure , so as to provide reference for the clinical drug use .METHODS：Embase, Pubmed, Cochrane library, CBM, CNKI, VIP and Wanfang database were retrieved for RCTs of valsartan and enalapril in patients with chronic heart failure .Meta-analysis was performed by using RevMan 5.3.RESULTS：Totally 14 literatures were involved , including 1665 patients with chronic heart failure .According to Meta-analysis , there were no significant differences between valsartan and enalapril group in changes of the total number of valid cases , left ventricular ejection fraction , left ventricular diastolic internal diameter or volume and left ventricular systolic end-stage or volume（P〉0.05）.The incidence of adverse drug reactions in valsartan group was significantly lower than that of enalapril group, with statistically significant difference （RR=0.45,95%CI=0.31-0.66,P〈0.01）.CONCLUSIONS：Current evidence shows that valsartan and enalapril have the same effect in treatment of chronic heart failure , yet valsartan is better than enalapril in the safety .

关 键 词：缬沙坦 依那普利 慢性心力衰竭 荟萃分析 

分 类 号：R972[医药卫生—药品]