沙库巴曲缬沙坦对心衰舒张功能治疗效果的Meta分析  

Effect of sacubitril/valsartan on cardiac diastolic function in heart failure patients:A meta-analysis

作　　者：李怡璇 方诚罡 王扬淦[1] LI Yixuan;FANG Chenggang;WANG Yanggan(Dept.of Cardiology,Zhongnan Hospital of Wuhan University,Wuhan 430071,Hubei,China)

机构地区：[1]武汉大学中南医院心血管内科,湖北武汉430071

出　　处：《武汉大学学报（医学版）》2023年第6期773-780,共8页Medical Journal of Wuhan University

基　　金：国家自然科学基金资助项目(编号:81873507)。

摘　　要：目的:采用循证医学的方法评价沙库巴曲缬沙坦对心衰舒张功能的治疗效果。方法:对各大数据库进行系统检索后,筛选报道舒张功能心脏超声指标的沙库巴曲缬沙坦治疗心衰的研究,进行数据处理及Meta分析。结果:共纳入16篇研究,其中9篇为随机对照试验,共包括2183名心衰患者。分析结果提示沙库巴曲缬沙坦较对照组可以显著改善左室舒张早期二尖瓣血流峰值/二尖瓣环根部舒张早期峰值速度[P<0.01,MD=-1.40,95%CI(-2.28,-0.52)]以及左心房容积指数[P<0.01,MD=-4.82,95%CI(-6.86,-2.77)]。且在非射血分数减少的心衰中可显著改善左室舒张早期及晚期二尖瓣血流峰值比值[P<0.05,MD=0.09,95%CI(0.01,0.18)]。结论:沙库巴曲缬沙坦较传统心衰一线推荐药物,如血管紧张素酶抑制剂及血管紧张素Ⅱ受体阻断剂类药物,对心衰的舒张功能改善效果更好。Objective:To evaluate the effect of sacubitril/valsartan on cardiac diastolic function in heart failure(HF)by the methods of evidence-based medicine.Methods:After systematically searching in major databases,we screened studies on available echocardiographic diastolic indices following sacubitril/valsartan treatment,and carried out data processing and meta-analysis.Results:A total of 16 studies were included,of which 9 were randomized controlled trials,involved a total of 2183 cases of HF.Sacubitril/valsartan significantly improved diastolic indices including the ratio of peak early diastolic mitral inflow velocity(E)to mitral annulus early diastolic velocity(e')(P<0.01,MD=-1.40,95%CI(-2.28,-0.52))and left atrial volume index(LAVi)(P<0.01,MD=-4.82,95%CI(-6.86,-2.77))in HF patients as compared with that respectively in control group,and improved early to late mitral inflow velocity ratio(E/A)(P<0.05,MD=0.09,95%CI(0.01,0.18))in the HF patients with mid-range or preserved ejection fraction.Conclusion:Sacubitril/valsartan treatment is superior to the traditional recommended drugs including ACEI/ARBs in improving cardiac diastolic function in HF patients.

关 键 词：沙库巴曲缬沙坦 血管紧张素受体脑啡肽酶抑制剂 心力衰竭 心脏舒张功能 超声心动图 

分 类 号：R541.61[医药卫生—心血管疾病]