左卡尼丁治疗扩张型心肌病的Meta分析

目的评价左卡尼丁治疗扩张型心肌病的有效性。方法检索Cochrane图书馆、Pubmed、CNKI、WANFANG、VIP数据库自建库以来至2011年12月公开发表的与左卡尼丁治疗扩张型心肌病相关的随机对照试验,并手工检索纳入文献的参考文献。对筛选出的文献查找全文,经质量评价最终纳入文献后采用Review Manger5.0软件对纳入的试验结果进行统计学分析。结果纳入11篇文献,共计684例患者,文献中8篇为B级,3篇为C级。Meta结果显示：在治疗终点时左卡尼丁组心功能改善情况优于对照组（OR=3.78,95%CI：2.50～5.74,P〈0.01）;左室射血分数（LVEF）高于对照组（WMD=3.70,95%CI：3.52～3.88,P〈0.01）;左室舒张末期内径（LVEDD）低于对照组（WMD=-3.18,95%CI：-4.53～-1.83,P〈0.01）;心输出量（CO）高于对照组（WMD=0.75,95%CI：0.61～0.89,P〈0.01）。结论左卡尼丁能显著提高扩张性心肌病患者左心室射血分数,改善患者心功能。由于纳入文章质量有限,建议临床审慎参考。

A Meta-analysis on L-carnitine in treatment of dilate cardiomyopathy

Objective To review the effectiveness of L-carnitine in the treatment of dilate cardiomyopathy.Methods The documents of randomized controlled trials(RCT) related to the treatment of dilate cardiomyopathy with L-carnitine published from the establishment time of the databases to Dec.2011 were retrieved from the databases of Cochrane Library,Pubmed,CNKI,WANFANG and VIP,and the reference in RCT were retrieved by hands at the same time.The full texts of screened documents were searched and given qualitative review,and then all included RCT were analyzed statistically by using Review Manger 5.0 software.Results There were 11 RCT included(684 patients),and among which 8 were grade B and 3 were grade C.The results of Meta-analysis showed as follows:at the end of the treatment,the improvement of heart function was better in L-carnitine group than that in control group(OR=3.78,95%CI:2.50～5.74,P<0.01),left ventricular ejection fraction(LVEF) was higher in L-carnitine group than that in control group(WMD=3.70,95%CI:3.52～3.88,P<0.01),left ventricular end-diastolic inner diameter(LVEDd) was lower in L-carnitine group than that in control group(WMD=-3.18,95%CI:-4.53～-1.83,P<0.01),and cardiac output(CO) was higher in L-carnitine group than that in control group(WMD=0.75,95%CI:0.61～0.89,P<0.01).Conclusion L-carnitine can significantly improve LVEF and heart function in the patients with dilated cardiomyopathy.