双水平气道正压通气联合重组人脑利钠肽治疗重症急性心力衰竭临床疗效的Meta分析  

Efficacy of bilevel positive airway pressure combined with recombinant human brain natriuretic peptide in the treatment of severe acute heart failure:a Meta-analysis

作　　者：刘振江 邵铭心 LIU Zhenjiang;SHAO Mingxin(Department of Emergency,Liaocheng People's Hospital,Liaocheng,Shandong,252000,China)

机构地区：[1]聊城市人民医院急诊科,山东聊城252000

出　　处：《当代医学》2024年第10期21-26,共6页Contemporary Medicine

摘　　要：目的探究双水平气道正压通气联合重组人脑利钠肽(rhBNP)治疗重症急性心力衰竭(AHF)的临床疗效。方法通过中国期刊全文数据库(CNKI)、中文科技期刊数据库(维普)、中国学术期刊数据库(万方)、PubMed、EMbase、Cochrane Library检索双水平气道正压通气联合rhBNP治疗重症AHF的随机对照试验,检索时间从建库至2022年7月1日,采用Cochrane风险偏倚评估工具评价文献质量,应用Rev-Man 5.4对文献进行Meta分析。结果共纳入8篇文献,患者579例。Meta分析结果显示,研究组总有效率高于对照组[RR=1.25,95%CI(1.14,1.36),P<0.00001]、撤机时间短于对照组[MD=-7.42,95%CI(-8.93,-5.92),P<0.00001]、N末端B型钠尿肽原(NT-proBNP)水平改善程度优于对照组[SMD=-2.23,95%CI(-3.55,-0.90),P=0.001]、24 h尿量多于对照组[SMD=1.86,95%CI(1.31,2.42),P<0.00001]。结论双水平气道正压通气联合rhBNP治疗重症AHF可明显缓解患者临床症状,降低NT-proBNP水平,缩短撤机时间,增加24 h尿量,改善患者心功能,降低病死率。Objective To explore the efficacy of bilevel positive airway pressure combined with recombinant human brain natriuretic peptide(rh-BNP)in the treatment of severe acute heart failure(AHF).Methods The randomized controlled trials of bi-level positive airway pressure ventilation combined with rhBNP in the treatment of severe AHF were retrieved from China National Knowledge Infrastructure(CNKI),Chinese Science and Technology Journal Database(VIP),China Academic Journal Database(Wanfang),PubMed,EMbase and Cochrane Library,the search time range was from the establishment of the database to July 1,2022,the Cochrane risk bias assessment tool was used to evaluate the quality of the literature,and RevMan 5.4 was used for Meta-analysis of the literature.Results Atotal of 8 articles were included,involving 579 cases of patients.Meta-analysis results showed that,the total effective rate in the study group was higher than that in the control group[RR=1.25,95%CI(1.14,1.36),P<0.00001],the weaning time was shorter than that in the control group[MD=−7.42,95%CI(−8.93,−5.92),P<0.00001],the improvement of N-terminal probrain natriuretic peptide(NT-proBNP)level was better than that in the control group[SMD=−2.23,95%CI(−3.55,−0.90),P=0.001],and the 24 h urine volume was more than that in the control group[SMD=1.86,95%CI(1.31,2.42),P<0.00001].Conclusion Bilevel positive airway pressure combined with rhBNP could effectively improve the clinical symptoms of patients with severe AHF,reduce NT-proBNP,shorten withdrawal time,increase 24 h urine volume,improve Heart function of paitents,reduce case fatality rate.

关 键 词：重症急性心力衰竭 双水平气道正压通气 重组人脑利钠肽 撤机时间 META分析 

分 类 号：R541.6[医药卫生—心血管疾病]