心肌收缩调节器治疗慢性收缩性心力衰竭的Meta分析  

Cardiac contractility modulation for the treatment of chronic systolic heart failure:a Meta-analysis

作　　者：朱艳芳 蔡小桃 蔡焕焕 ZHU Yanfang;CAI Xiaotao;CAI Huanhuan(Department 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,湖北省武汉市430071

出　　处：《广西医学》2023年第18期2249-2255,共7页Guangxi Medical Journal

基　　金：湖北省自然科学基金(2022CFB704)。

摘　　要：目的系统评价心肌收缩调节器(CCM)治疗慢性收缩性心力衰竭的有效性和安全性。方法计算机检索PubMed、ClinicalTrials.gov、Embase、万方数据知识服务平台及中国知网数据库,筛选关于CCM治疗慢性收缩性心力衰竭的病例对照研究。提取数据和评价文献质量后,采用RevMan 5.4软件进行Meta分析。结果共纳入6篇文献,包括1089例患者,其中CCM组544例、对照组545例。Meta分析结果显示,与对照组相比,CCM组患者的心力衰竭加重再住院降低,明尼苏达心力衰竭生活质量问卷评分增加,6 min步行试验距离延长(P<0.05),但两组患者的全因死亡率、全因再住院率及心律失常发生率差异无统计学意义(P>0.05)。结论与单纯药物治疗相比,CCM联合药物治疗可更有效地提高慢性收缩性心力衰竭患者的运动耐量,改善其心功能及生活质量,降低心力衰竭加重再住院的风险,有望成为治疗该病的新手段。Objective To systematically evaluate the effectiveness and safety of cardiac contractility modulation(CCM)for the treatment of chronic systolic heart failure.Methods The databases of PubMed,ClinicalTrial.gov,Embase,Wanfang Data Knowledge Service Platform,and China National Knowledge Infrastructure were retrieved by computer,and the case-control trials related to CCM for treating chronic systolic heart failure were screened.After data extraction and literature quality evaluation,Meta analysis was performed by using RevMan 5.4 software.Results A total of 6 literature was enrolled,including 1089 patients,therein,there were 544 cases in the CCM group,and 545 cases in the control group.The results of Meta-analysis revealed that compared with the control group,the CCM group exhibited reduced readmission because of aggravation of heart failure,an increased score of Minnesota Living with Heart Failure Questionnaire,and a prolonged distance of 6-minute walk test(P<0.05),but no statistically significant difference in the all-cause mortality,all-cause readmission rate,and incidence rate of arrhythmia was found between the two groups(P>0.05).Conclusion Compared with single drug therapy,CCM combined with drug therapy can effectively improve exercise tolerance of patients with chronic systolic heart failure,ameliorate their cardiac function and quality of life,reduce risk of readmission because of heart failure aggravation,which is expected to be regarded as novel approach to this disease.

关 键 词：慢性收缩性心力衰竭 心肌收缩调节器 有效性 安全性 META分析 

分 类 号：R541.6[医药卫生—心血管疾病] R454[医药卫生—内科学]