伊伐布雷定在急性心肌梗死患者中应用的可行性  

The feasibility of ivabradine in patients with acute myocardial infarction

作　　者：汪雁博[1] 郝国贞[1] WANG Yanbo;HAO Guozhen(The Fifth Department of Cardiology,the Second Hospital of Hebei Medical University,Shijiazhuang,Hebei,050000,China)

机构地区：[1]河北医科大学第二医院心血管内五科,河北石家庄050000

出　　处：《当代医学》2023年第32期1-6,共6页Contemporary Medicine

基　　金：河北省医学科学研究课题(20190523)。

摘　　要：目的探讨伊伐布雷定在急性心肌梗死(AMI)患者中应用的可行性。方法检索PubMed、迈特思创数据库、中国期刊全文数据库(中国知网)、中文科技期刊数据库(维普)和中国学术期刊数据库(万方),检索时间均为从建库至2021年6月。中文检索词为“急性心肌梗死”“伊伐布雷定”“心力衰竭”“心率”,英文检索词为“acute myocardialinfarction”“ivabradine”“heart failure”“heart rate”,同时进行MeSH及自由词检索,阅读文献后进行溯源检索。由2名研究者独立进行文献质量评价和相关数据提取。采用RevMan 5.0软件进行统计学分析。结果初检文献159篇,最终入选符合条件的文献9篇,患者1331例。Meta分析结果显示,伊伐布雷定组出院时心率低于对照组[加权均数差(WMD)=−8.04,95%CI(−11.09,−4.99),P<0.00001];两组出院时N末端B型钠尿肽原(NT-ProBNP)水平比较差异无统计学意义;伊伐布雷定组出院时收缩压高于对照组[WMD=3.47,95%CI(1.55,5.40),P=0.0004];随访1个月,两组心率和左心室射血分数(LVEF)水平比较差异无统计学意义,伊伐布雷定组NT-ProBNP水平明显低于对照组[WMD=−155.00,95%CI(−251.44,−58.57),P=0.002]。结论伊伐布雷定具有降低心率和随访期间NT-ProBNP水平的作用,在AMI患者中应用是可行的。Objective To explore the feasibility of ivabradine in patients with acute myocardial infarction(AMI).Methods The databases of PubMed,Metstron Database,China National Knowledge Infrastructure(CNKI),Chinese Science and Technology Journal Database(VIP)and China Academic Journal Database(Wanfang)were searched from the establishment of the database to June 2021.The keywords were"acute myocardial in-farction""ivabradine""heart failure""and"heart rate",at the same time,MeSH and free word search were performed,and traceability search was per-formed after reading the literature.Two researchers independently evaluated the quality of the literature and extracted relevant data.RevMan 5.0 soft-ware was used for statistical analysis.Results A total of 159 articles were initially examined,and 9 eligible articles were finally selected,involving 1331 cases of patients.The results of Meta-analysis showed that the heart rate at discharge in the ivabradine group was lower than that in the control group(weighted mean difference[WMD]=−8.04,95%CI[−11.09,−4.99],P<0.00001).There was no statistically significant difference in the level of NT-Pro BNP at discharge between the two groups.The level of systolic blood pressure at discharge in the ivabradine group was higher than that in the control group(WMD=3.47,95%CI[1.55,5.40],P=0.0004).At 1 month follow-up,there were no significant differences in heart rate and left ven-tricular ejection fraction(LVEF)levels,and the level of N-terminal pro-brain natriuretic peptide(NT-ProBNP)in the ivabradine group was signifi-cantly lower than that in the control group(WMD=−155.00,95%CI[−251.44,−58.57],P=0.002).Conclusion It is feasible of ivabradine on reduc-ing the level of heart rate and NT-ProBNP at 1 month after discharge in patients with AMI.

关 键 词：急性心肌梗死 伊伐布雷定 可行性 META分析 

分 类 号：R542.22[医药卫生—心血管疾病]