伊伐布雷定联合β受体阻断剂治疗慢性心力衰竭的有效性和安全性的Meta分析  

Meta-Analysis on Efficacy and Safety of Ivabradine Combined withβ-Blockers in the Treatment of Chronic Heart Failure

作　　者：陈琮玲 杨贤 吴韩 张若彬 殷嘉晨 兰希 张晋萍 CHEN Congling;YANG Xian;WU Han;ZHANG Ruobin;YIN Jiachen;LAN Xi;ZHANG Jinping(Dept.of Pharmacy,Nanjing Drum Tower Hospital,Nanjing 210008,China;School of Basic Medicine and Clinical Pharmacy,China Pharmaceutical University,Nanjing 211198,China;Dept.of Cardiology,Nanjing Drum Tower Hospital,Nanjing 210008,China)

机构地区：[1]南京鼓楼医院药学部,南京210008 [2]中国药科大学基础医学与临床药学学院,南京211198 [3]南京鼓楼医院心脏科,南京210008

出　　处：《中国医院用药评价与分析》2024年第4期459-464,共6页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：国家自然科学基金面上项目(No.81970296);南京市卫生科技发展专项资金项目(No.JQX20006)。

摘　　要：目的:系统评价伊伐布雷定(IVA)联合β受体阻断剂治疗慢性心力衰竭(CHF)的有效性和安全性。方法:计算机检索PubMed、Embase、the Cochrane Library、Web of Science、中国知网、万方数据库、维普数据库和中国生物医学文献数据库等,搜集IVA联合β受体阻断剂治疗CHF的随机对照试验(观察组患者予以IVA联合β受体阻断剂治疗,对照组患者单纯使用β受体阻断剂治疗),检索时限为建库至2023年4月12日,应用RevMan 5.4和Stata 16软件进行Meta分析。结果:共纳入39项研究,涉及3794例患者。Meta分析结果显示,观察组患者总有效率显著高于对照组,心率显著低于对照组,心功能指标显著优于对照组(左心室射血分数高于对照组,左心室收缩末期内径、左心室舒张末期内径低于对照组,6 min步行距离长于对照组),不良反应发生率显著低于对照组,差异均有统计学意义(P<0.05)。结论:IVA联合β受体阻断剂在提高CHF患者总有效率、降低心率和改善心功能方面疗效显著,安全性好,值得临床推广应用。OBJECTIVE:To systematically review the efficacy and safety of ivabradine(IVA)combined withβ-blockers in the treatment of chronic heart failure(CHF).METHODS:PubMed,Embase,the Cochrane Library,Web of Science,CNKI,Wanfang Data,VIP and CBM were retrieved to collect randomized controlled trials of IVA combined withβ-blockers in the treatment of CHF(the observation group was treated with IVA combined withβ-blocker,while the control group receivedβ-blocker alone).The retrieval time was from the establishment of the database to Apr.12th,2023.Meta-analysis was performed by using RevMan 5.4 and Stata 16 software.RESULTS:A total of 39 studies including 3794 patients were enrolled.Meta-analysis showed that the total effective rate in the observation group was significantly higher than that in the control group,the heart rate was significantly lower than that in the control group,and the cardiac function indicator was significantly better than that in the control group(left ventricular ejection fraction was higher than that in the control group,left ventricular end-systolic diameter and left ventricular end-diastolic diameter were lower than that in the control group,6 min walking distance was longer than that in the control group),and the incidence of adverse reactions was significantly lower than that in the control group,with statistically significant differences(P<0.05).CONCLUSIONS:IVA combined withβ-blocker has significant efficacy and good safety in improving the total effective rate,reducing heart rate and improving cardiac function in patients with CHF,which is worthy of clinical promotion and application.

关 键 词：慢性心力衰竭 伊伐布雷定 Β受体阻断剂 随机对照试验 META分析 

分 类 号：R972[医药卫生—药品]