曲美他嗪治疗扩张型心肌病的Meta分析

目的评价联用曲美他嗪治疗扩张型心肌病的疗效及安全性。方法计算机检索Cochrane图书馆临床对照试验库、PubMed、EBSCO、万方数据库、中国学术期刊全文数据库、中国生物医学文献数据库、维普数据库，收集曲美他嗪治疗扩张型心肌病的随机对照试验，按纳人和排除标准由2名评价者独立选择文献、提取资料，交叉核对并进行方法学质量评估，使用RevMan5．0软件进行Meta分析。结果共纳入11项研究，644例患者。Meta分析结果显示：与常规治疗比较，联用曲美他嗪明显增加左室射血分数（WMD=4．14，95％Ch3．16—5．12，P〈0．01），减少左室舒张末期内径（WMD=-4．12，95％Ch-4．88-3．36，P〈0．01），减少左室收缩末期内径（WMD=-3．83，95％CI：-6．16-1．5，P〈0．01），增加6分钟步行距离（WMD=38．95，95％CI：29．85—48．06，P〈0．01），并减少再入院率。结论现有的证据提示联用曲美他嗪可改善患者心功能指标，减少患者再住院率。但受纳入文献质量的限制，其治疗扩张性心肌病的疗效的评价期待更多高质量的随机对照双盲研究，以做进一步的评价。

A Meta-analysis on curative effect and safety of trimetazidine in treatment of dilated cardiomyopathy

Objective To review the curative effect and safety of trimetazidine in treatment of dilated cardiomyopathy.Methods The databases of Cochrane Controlled Trials Register/CENTRAL,PubMed,EBSCO,WangFang Database,CJFD,CBM and VIP Database were retrieved with computers for collecting randomized controlled trials(RCT) about the treatment of dilated cardiomyopathy with trimetazidine.The RCT were selected by two researchers independently according to inclusion and exclusion criterions and materials were extracted,checked crossly and given methodological quality evaluation.The Meta-analysis was conducted by using RevMan 5.0 software.Results There were totally 11 RCT enclosed,and the results of Meta-analysis showed that trimetazidine increased significantly LVEF(WMD=4.14,95%CI:3.16 to 5.12,P<0.01),decreased LVEDd(WMD=-4.12,95%CI:-4.88 to-3.36,P<0.01) and LVESd(WMD=-3.83,95%CI:-6.16 to-1.5,P<0.01),increased 6MWD(WMD=38.95,95% CI:29.85 to 48.06,P<0.01),and reduced readmission rate.Conclusion The existing evidences indicate that trimetazidine can improve the heart functional indexes and reduce readmission rate.As the limitation of the quality of enclosed literature,more randomized controlled double-blinded trials with higher quality are required for further reviewing the curative effect of trimetazidine on dilated cardiomyopathy.