糖皮质激素治疗心力衰竭疗效与安全性的Meta分析  

Meta-analysis of the Efficacy and Safety of Glucocorticoids in the Treatment of Heart Failure

作　　者：赵维 廖荣宏[1] 王爱华[1] ZHAO Wei;LIAO Rong-hong;WANG Ai-hua(Department of Cardiology,Yongchuan Hospital,Chongqing Medical University,Chongqing 402160,China)

机构地区：[1]重庆医科大学附属永川医院心血管内科,重庆402160

出　　处：《医学信息》2018年第14期70-74,共5页Journal of Medical Information

摘　　要：目的评估糖皮质激素治疗心力衰竭的有效性及安全性。方法计算机检索Pub Med、Cochrane Library、OVID、MEDLINE、EMBASE、CNKI、VIP、万方等数据库,检索时间至2017年11月,纳入常规治疗+糖皮质激素(激素组)对比常规治疗(对照组)治疗心力衰竭的随机对照试验(RCT),统计数据采用Rev Man5.3软件进行Meta分析。结果该研究共纳入11个RCT,患者601例,Meta分析结果显示:激素组能降低患者全因死亡率[OR:0.20,95%CI(0.08,0.51),P=0.0009],改善心功能[OR:6.19,95%CI(3.22,9.51),P<0.0001]及肾功能[WMD:-16.94,95%CI(-29.47,-4.41),P=0.008],增加尿量[WMD:1253.62,95%CI(788.26,1718.99),P<0.0001]与对照组比较,差异具有统计学意义,两组患者不良反应发生率[OR:0.65,95%CI(0.34,1.25),P=0.20]比较,差异无统计学意义。结论糖皮质激素可能作为辅助治疗心力衰竭的有效手段。Objective To evaluate the efficacy and safety of glucocorticoids in the treatment of heart failure. Methods The computer was searched for Pub Med,Cochrane Library,OVID,MEDLINE,EMBASE,CNKI,VIP,Wanfang and other databases.The search time was from November 2017,and it was included in the routine treatment＋glucocorticoid（hormone group）compared with conventional treatment（control group）.Randomized controlled trial（RCT）of heart failure,statistical analysis using Rev Man5.3 software for meta-analysis.Results The study included 11 RCTs with 601 patients.Meta-analysis showed that the hormone group reduced all-cause mortality in patients [OR：0.20,95% CI（0.08, 0.51）,P=0.0009],improving cardiac function[OR：6.19,95% CI（3.22,9.51）,P〈0.0001]and renal function[WMD：-16.94,95% CI（-29.47,-4.41）,P=0.008],increased urine output [WMD：1253.62,95 %CI（788.26,1718.99）,P〈0.0001]compared with the control group,the difference was statistically significant.The incidence of adverse reactions in the two groups[OR：0.65,95% CI（0.34,1.25）,P =0.20],the difference was not statistically significant.Conclusion Glucocorticoid may be an effective means of adjuvant treatment of heart failure.

关 键 词：糖皮质激素 心力衰竭 META分析 

分 类 号：R541.6[医药卫生—心血管疾病]