硝普钠联合多巴胺治疗心衰的Meta分析

目的通过临床对照较为全面地评估硝普钠联合多巴胺治疗心衰患者的心功能改善情况，反映联合用药治疗心衰的疗效等。方法计算机检索中国知网关于硝普钠、一tk,衰的参考文献。检索时限为2000年至2012年12月。由3名研究者对纳入研究的质量进行严格评价和资料提取，对符合质量标准的RCT进行Meta分析。统计学分析采用RevMan5．1软件。结果共纳入16个RCT，共1240个患者。Meta分析结果显示：与标准治疗相比，应用硝普钠联合多巴胺治疗心衰可增加患者射血分数[MD=5．71，95％CI（4．34，7．07），P〈0．00001]，减少患者左室舒张末内径[MD=2．53，95％CI（0．74，4．32），P=0．006]，提高有效率[OR=6．04，95％CI（4．14，8．82），P〈0．00001]，左室收缩末内径无改善[MD=1．35，95％CI（-3．17，5．88），P=0．56J。结论硝普钠联合多巴胺治疗心衰较标准治疗的有效率明显提高，可明显改善患者心功能，表现在增加射血分数，减小左室舒张内径上。

Meta-analysis on the combined treatment of sodium nitroprusside and dopamine for heart failure

Objective To evaluate the efficacy of the combined treatment of sodium nitroprusside and dopamine for heart failure patients and the improvement of cardiac function. Methods China National Knowledge Infrastructure （CNKI） database was searched for the literatures on the clinical trials of sodium nitroprusside combined dopamine in the treatment of heart failure patients using key words ： ＂sodium nitroprusside＂, and ＂heart failure＂. Retrieval time was from 2000 to December,2012. A manual search of those trials was simultaneously performed. A recta-analysis was conducted on the outcome of the included trials with the assistance of Revman 5.1 software. Results Totally 16 of the randomized controlled trials （RCT） were discovered including 1240 patients. Meta-analysis showed that compared with standard therapy, the left ventricular ejection fraction of the combined treatment group was improved [ MD = 5. 71,95% CI（ 4. 34, 7.07） ,P〈 0. 000 01 ] ; the left ventricular end diastolic diameter was reduced [ MD = 2. 53,95% CI （ O. 74,4. 32 ）, P = 0. 006 ] ; the efficiency was improved [ OR = 6.04,95% CI （ 4. 14, 8.82 ）, P 〈 0. 000 01 ] ; the left ventricular end systolic diameter was not reduced [MD= 1.35,95%C1（-3.17,5. 88） ,P=0.56]. Conclusions Sodium nitroprusside combined dopamine treatment for heart failure could obviously improve the efficiency, improve patients with cardiac function,improve ejection fraction, and reduce the left ventricular end diastolic diameter.