托伐普坦治疗心力衰竭有效性和安全性的系统评价

目的：评价托伐普坦治疗心力衰竭的有效性和安全性。方法检索Cochrane图书馆、EMBASE、PubMed、中国期刊全文数据库（ CNKI）、维普数据库（ VIP）、万方数字知识平台相关托伐普坦治疗心力衰竭的随机对照试验，运用 Review manager 5．2软件进行系统评价。结果共纳入9篇文献，包括6016例患者，其中托伐普坦组3000名，安慰剂组3016名。结果托伐普坦组相比安慰剂组能更好的提高患者的血清钠浓度，差异有统计学意义，能增加患者的尿量，减轻患者的体重，对于患者心率、血压、血钾浓度、严重不良事件发生率和死亡率，托伐普坦组与安慰剂组相比没有统计学差异。结论托伐普坦治疗心力衰竭有一定疗效，可改善心衰症状，但仍需更多大样本高质量的研究证实。

A Systematic Review of Efficacy and Safety of Tolvaptan for Heart Failure

ABSTRACT:OBJECTIVE To evaluate the efficacy and safety of tolvaptan treatment in heart failure .METHODS Cochrane Library,EMBASE,PubMed,Chinese Journal Full-text Database (CNKI),VIP database (VIP) were searched by computer for randomized controlled trials ( RCT) of tolvaptan for patients with heart failure .The statistic analysis was performed with the Review manager 5.2.RESULTS This review included 9 literatures(6016 cases of patients,3000 of the tolvaptan group,3016 of the placebo group).The results of Meta-analysis showed the following facts:tolvaptan group compared to placebo group increased serum sodium concentration with statistical significance〔MD2.73,95%CI(1.91,3.56)〕;tolvaptan group compared to placebo group increased urine volume〔SMD1.42, 95%CI(0.52,2.33)〕;tolvaptan group compared to placebo group reduced body weight〔MD-0.99,95% CI( -1.23,-0.75)〕;no significant difference in serum potassium ,heart rate,blood pressure,serious adverse events and? 82?mortality between tolvaptan group and placebo group were observed .CONCLUSION The result of Meta-analysis shows that the tolvaptan can improve the therapeutic effect of heart failure and is safe .However ,for the possibility of bias due to the few high quality RCTs ,more large–scale and high-quality RCTs are needed to support this conclu-sion.