美托洛尔治疗风湿性心脏病的系统评价

目的应用Meta分析方法对美托洛尔治疗风湿性心脏病的临床疗效和安全性进行系统评价。方法计算机检索PubMed、Cochrane Library、EMBASE、VIP、CNKI、CBM等数据库,并辅手工检索和其他检索,全面收集有关美托洛尔治疗风湿性心脏病的随机对照试验,按照Cochrane LibraryHandbook推荐的质量评价方法评价纳入研究的质量,并对符合纳入标准的研究用RevMan5.0软件对数据进行Meta分析。结果纳入6个研究,共485例病人。Meta分析结果显示:与基础治疗相比,美托洛尔治疗风湿性心脏病可降低病人病死率OR=0.49,95%CI(0.30,0.79),P=0.004]和再次入院率OR=0.11,95%CI(0.06,0.22),P<0.00001]、可提高NYHA心功能OR=-0.74,95%CI(-1.01,-0.48),P<0.00001]等。结论目前证据表明,美托洛尔治疗风湿性心脏病有效,且不良反应少,但纳入的研究质量均不高,因此,有必要开展更多高质量、多中心的随机对照试验对其疗效及安全性进一步予以证实。

Rheumatic heart disease with metoprolol:a systematic review

Aim To systematically review the efficacy and safety of metoprolol in treatment of rheumatic heart disease(RHD)by Meta-analysis.Methods By computerized retrieving PubMed,EMBASE,the Cochrane Library,EMBASE,VIP,CNKI,CBM etc.randomized controlled trials(RCTs)on metoprolol in treatment of RHD were collected.Data were strictly extracted using the fundamental evaluation method recommended in Cochran Handbook and Meta-analysis was performed using Rev Man 5.0 software.Results Six trials involving 485 patients met the inclusion criteria.Meta-analysis showed that:compared with basic therapy,metoprolol in treatment of RHD could reduce the fatality rate OR=0.49,95% CI(0.30,0.79),P=0.004],re-admission rate OR=0.11,95% CI(0.06,0.22),P<0.000 01],could improve NYHA heart function OR=-0.74,95% CI(-1.01,-0.48),P<0.000 01] and so on.Conclusion The current evidence suggests that metoprolol in treatment of RHD is effective,but the quality of research is poor,therefore,it is necessary to carry out more high-quality,multi-center RCTs to further confirm its efficacy and security.