左卡尼汀联合参麦注射液治疗缺血性心肌病心力衰竭效果的Meta分析  

Therapeutic effect of levocarnitine combined with Shenmai injection on heart failure caused by ischemic cardiomyopathy:a meta-analysis

作　　者：黄强 张树丹[2] HUANG Qiang;ZHANG Shu-dan(Pharmacy Department,Anshan Central Hospital,Anshan,Liaoning,114000,China)

机构地区：[1]鞍山市中心医院药剂科,辽宁鞍山114000 [2]大连市中医医院药学部

出　　处：《心血管康复医学杂志》2025年第2期216-221,共6页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:系统评价左卡尼汀联合参麦注射液治疗缺血性心肌病心力衰竭的疗效及安全性。方法:检索PubMed、Cochrane Library、EMbase、CBM、知网、万方及维普网络数据库从建库至2023年6月12日关于左卡尼汀联合参麦注射液与常规治疗比较治疗缺血性心肌病心力衰竭的随机对照试验(Random controlled trials,RCTs)。使用RevMan 5.4软件进行Meta分析,合并计算95%置信区间的比值比(OR)或均数差(MD)。结果:纳入21篇文献,总计2055名患者[平均年龄(63.86±9.90)岁,男性占61.27%],合并分析显示:左卡尼汀联合参麦注射液总有效率(OR=5.04,95%CI 3.78~6.71,P<0.001)、左室射血分数(MD=6.10,95%CI 5.18~7.02,P<0.001)、每搏量(MD=10.64,95%CI 7.42~13.85,P<0.001)、心排出量(MD=0.85,95%CI 0.74~0.97,P<0.001)、左室短径缩短率(MD=5.27,95%CI 4.16~6.39,P<0.001)显著高于常规治疗,左室舒张末期内径(MD=-5.64,95%CI-7.31~-3.98,P<0.001)、左室收缩末期内径(MD=-5.08,95%CI-6.08~-4.09,P<0.001)显著低于常规治疗。两组不良反应发生率无显著差异(P=0.220)。结论:当前研究证据表明:左卡尼汀与参麦注射液联合治疗缺血性心肌病心力衰竭疗效较好,安全性较好。Objective:To review systematically the curative effect and safety of levocarnitine combined with Shenmai injection in the treatment of heart failure caused by ischemic cardiomyopathy.Methods:We searched the databases of PubMed,Cochrane Library,EMbase,CBM,CNKI,WanFang and VIP for randomized controlled trials(RCTs)comparing the effect upon heart failure caused by ischemic cardiomyopathy between levocarnitine combined with Shenmai injection versus standard treatment from the establishment to June 12 th,2023.The pooled odds ratio(OR)or mean difference(MD)with 95%confidence interval(CI)were calculated with a Meta-analysis using the RevMan 5.4 software.Results:21 eligible literatures were included,involving 2055 patients[mean age(63.86±9.90)years,males 61.27%].Pooled analysis showed that levocarnitine combined with Shenmai injection significantly improved the total effective rate(OR=5.04,95%CI 3.78~6.71,P<0.001),left ventricular ejection fraction(MD=6.10,95%CI 5.18~7.02,P<0.001),stroke volume(MD=10.64,95%CI 7.42~13.85,P<0.001),cardiac output(MD=0.85,95%CI 0.74~0.97,P<0.001),left ventricular fractional shortening(MD=5.27,95%CI 4.16~6.39,P<0.001),and significantly reduced left ventricular end-diastolic diameter(MD=-5.64,95%CI-7.31~-3.98,P<0.001)and left ventricular end-systolic diameter(MD=-5.08,95%CI-6.08~-4.09,P<0.001)than standard treatment.There were no significant differences in the adverse reaction rate between groups(P=0.220).Conclusion:Current research evidence suggests that levocarnitine combined with Shenmai injection had better efficacy on the heart failure caused by ischemic cardiomyopathy,with good safety.

关 键 词：心力衰竭 左卡尼汀 参麦注射液 META分析 

分 类 号：R541.61[医药卫生—心血管疾病]