胺碘酮治疗心脏瓣膜置换术后心房颤动患者临床疗效的Meta分析

目的探讨胺碘酮治疗心脏瓣膜置换术后心房颤动患者的临床效果,旨在为提高瓣膜置换术后心房颤动患者疗效提供参考依据。方法计算机检索PubMed、Web of Science、WILEY医学及护理学科库、Cochrane Library、CNKI、万方数据库、维普数据库、中国生物医学文献数据库,查找自建库至2019年9月24日有关胺碘酮治疗心脏瓣膜置换术后心房颤动患者临床疗效的随机对照试验(RCT)。经过2名研究员独立文献筛选、文献质量评价后提取相关数据,采用Revman 5.3软件进行定量综合分析。结果共纳入7篇文献,其中中文文献6篇,英文文献1篇;累计710例患者,试验组363例,对照组347例。采用Revman 5.3软件行定量合成,结果显示,使用胺碘酮治疗瓣膜置换术后心房颤动能够提高心房颤动转复率(RR=1.36,95%CI:1.20~1.54,P<0.05),且窦性心律维持率提高(RR=1.41,95%CI:1.16~1.72,P=0.002),其可以缩短ICU监护时间(MD=-1.09,95%CI:-1.32^-0.86,P<0.05)和总住院天数(MD=-3.92,95%CI:-4.25^-3.59,P<0.05)。结论胺碘酮治疗瓣膜置换术后心房颤动可以提高心房颤动转复率和窦性心律维持率,缩短ICU监护时间和总住院天数,值得临床推广应用。

Clinical effect of amiodarone on atrial fibrillation after heart valve replacement:a Meta-analysis

Objective To investigate the clinical effect of amiodarone on patients with atrial fibrillation after heart valve replacement,and to provide reference basis for improving the efficacy of patients with atrial fibrillation after heart valve replacement.Methods The PubMed,Web of Science,WILEY medical and nursing discipline database,Cochrane Library,CNKI,Wanfang database,VIP database and China Biology Medicine disc were searched by computer.Randomized controlled trials(RCTs)about amiodarone treating patients with atrial fibrillation after heart valve replacement were searched from the establishment of the database to 24th September,2019.After two people's independent literature screening and literature quality evaluation,relevant data were extracted and quantitative comprehensive analysis was conducted with Revman 5.3 software.Results A total of 7 articles were included,including 6 Chinese articles and 1 English article.There were 710 patients in total,including 363 cases in the experimental group and 347 cases in the control group.Quantitative synthesis was performed with Revman 5.3 software,and the results showed that amiodarone treatment for atrial fibrillation after valve replacement could improve the recovery rate of atrial fibrillation(RR=1.36,95%CI:1.20-1.54,P<0.05).The rate of sinus rhythm maintenance was increased(RR=1.41,95%CI:1.16-1.72,P=0.002),the ICU monitoring time was shortened(MD=-1.09,95%CI:-1.32--0.86,P<0.05),and the total days in hospital was reduced(MD=-3.92,95%CI:-4.25--3.59,P<0.05).Conclusions Amiodarone treatment for atrial fibrillation after valve replacement can improve the recovery rate of atrial fibrillation and the rate of sinus rhythm maintenance,reduce the ICU monitoring time and the total days in hospital,which is worthy of clinical application.