尼非卡兰治疗心房颤动复律有效性和安全性系统评价  

Efficacy and Safety of Nifekalant in Cardioversion of Atrial Fibrillation:A Systematic Review

作　　者：李国熊 余坷坪 王真 李鹏 周涛 LI Guoxiong;YU Keping;WANG Zhen;LI Peng;ZHOU Tao(Chongqing Hospital of University of Chinese Academy of Sciences,Chongqing,China 400013;The First Affiliated Hospital of Chongqing Medical and Pharmaceutical College,Chongqing,China 400060)

机构地区：[1]中国科学院大学重庆医院,重庆400013 [2]重庆医药高等专科学校附属第一医院,重庆400060

出　　处：《中国药业》2020年第13期85-89,共5页China Pharmaceuticals

基　　金：重庆市科卫联合医学科研项目[2018MSXM056]。

摘　　要：目的系统评价尼非卡兰用于心房颤动复律的有效性和安全性。方法计算机检索PubMed,The Cochrane Library,Embase,CNKI,CBM,VIP,WanFang Data数据库,检索尼非卡兰用于心房颤动复律的随机对照试验(RCT)和平行对照试验。由2位研究者独立筛选文献、提取资料和评价纳入研究的偏倚风险后,采用RevMan 5. 3软件进行Meta分析。结果共纳入6项研究455例患者,其中试验组217例,对照组238例。Meta分析结果显示,两组患者的心房颤动复律有效率差异无统计学意义[RR=1. 09,95%CI (0. 98,1. 22),P=0. 11,Z=1. 59];严重不良反应发生率差异无统计学意义[RR=1. 66,95%CI (0. 34,8. 12),P=0. 53,Z=0. 63];总体不良反应发生率更低[RR=0. 23,95%CI (0. 09,0. 64),P=0. 004,Z=2. 84]。结论其他药物复律无效或不能耐受的心房颤动患者可使用尼非卡兰来恢复窦性心律,但需进行心电密切监护,尤其需监控QTc延长防止尖端扭转型室性心动过速(TdP)的发生。Objective To systematically review the efficacy and safety of nifekalant in cardioversion of atrial fibrillation.Methods PubMed,Cochrane Library,EMbase,CNKI,CBM,VIP and WanFang data were searched for randomized controlled trials(RCTs)and Non-Randomized Concurrent Controlled Trial of nifekalant in cardioversion of atrial fibrillation.Two reviewers independently screened literature extracted data and assessed the risk of bias of included studies.Meta-analysis was performed using RevMan 5.3 software.Results A total of 6 studies involving 455 patients were included,of which 217 patients in the experimental group and 238 patients in the control group.The results of meta-analysis showed that there was no statistically significant difference in efficacy of nifekalant in conversion of atrial fibrillation between the two groups[RR=1.09,95%CI(0.98,1.22),P=0.11,Z=1.59],as well as severe adverse reaction[RR=1.66,95%CI(0.34,8.12),P=0.53,Z=0.63],while the general adverse reactions of the experimental group had significant difference in comparison with control group[RR=0.23,95%CI(0.09,0.64),P=0.004,Z=2.84].Conclusion The current evidence indicates that patients with atrial fibrillation who are ineffective or unable to tolerate cardioversion with other drugs can choose nifekalant.But it needs to be administrated under close monitoring of ECG,especially to monitor QTc prolongation to prevent torsadesde points(TdP).

关 键 词：尼非卡兰 心房颤动 房颤复律 META分析 有效性 安全性 

分 类 号：R969.4[医药卫生—药理学] R972.2[医药卫生—药学]