琥珀酸美托洛尔与曲美他嗪联合应用于冠心病心力衰竭的Meta分析

目的 系统评价琥珀酸美托洛尔与曲美他嗪联合应用于冠心病心力衰竭的临床疗效。方法 基于冠心病心力衰竭、琥珀酸美托洛尔、曲美他嗪等主题,基于CNKI、万方、维普、龙源等数据库,对其中相关随机对照试验(RCT)进行检索,最终纳入文献11篇。评估文献质量后,从中提取相关指标总有效率、收缩压(SBP)、舒张压(DBP)、心率(HR)、左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、左心射血分数(LVEF)、血浆脑肽尿肽(BNP)、不良反应发生率]行系统性分析。结果 观察总有效率明显高于对照组(OR=3.70,95%CI:2.16~6.33,Z=4.76,P<0.01);观察组SBP、DBP、HR、LVEDD、LVESD、BNP均明显低于对照组(P<0.05);观察组LVEF%明显高于对照组(MD=4.07,95%CI:1.60~6.55,Z=3.22,P=0.0001);观察不良反应发生率明显低于对照组(OR=0.12,95%CI:0.06~0.24,Z=6.11,P<0.01)。结论 琥珀酸美托洛尔联合曲美他嗪治疗能够有效改善冠心病心力衰竭患者心肺功能,临床疗效优于常规治疗,并且用药安全性较高。

Efficacy of Metoprolol Succinate combined with Trimetazidine on coronary heart disease and heart failure: a meta-analysis

Objective To systematically evaluate the clinical efficacy of metoprolol succinate combined with trimetazidine on coronary heart disease(CHD) and heart failure. Methods Relevant randomized controlled trials(RCT) were searched from the databases of “CNKI”, “Wanfang”, “Weipu”, “Longyuan”, etc with the key words of “coronary heart disease”, “heart failure”, “Metoprolol Succinate”, “Trimetazidine”, eleven articles were included Finally. Throught evaluating quality of the literature, relevant indicators including total effective rate, systolic blood pressure(SBP), diastolic blood pressure(DBP), heart rate(HR), left ventricular end diastolic diameter(LVEDD), left ventricular end systolic diameter(LVESD), left ventricular ejection fraction(LVEF), plasma brain peptide urinary peptide(BNP), incidence of adverse reactions were performing for systematic analysis. Results The total effective rate in the observation was significantly higher than that in the control group (OR=3.70, 95%CI: 2.16-6.33, Z=4.76, P<0.01); Compared with the control group, SBP, DBP, HR, LVEDD, LVESD and BNP in the observation group were significantly lower (P<0.05); LVEF percent in the observation group was significantly higher (MD=4.07, 95%CI: 1.60-6.55, Z=3.22, P=0.0001); incidence of adverse reactions in the observation group was significantly lower (OR=0.12, 95%CI: 0.06-0.24, Z=6.11, P<0.01). Conclusion Using Metoprolol Succinate combined with Trimetazidine on CHD and heart failure can effectively improve the cardiopulmonary function of patients. The clinical effect is better than conventional treatment with higher safety of medication.