倾斜训练对血管迷走性晕厥患者疗效和安全性的meta分析
A meta analysis on efficacy and safety of tilt training in patients with vasovagal syncope
曾庆红 1胡方振 1周雅文 1王杨淦1
作者信息
- 1. 武汉大学中南医院心血管内科 湖北 武汉 430071
- 折叠
摘要
目的:采用循证医学的方法探讨倾斜训练对血管迷走性晕厥患者的疗效和安全性.方法:依据所制定的检索策略词在各大数据库搜索了自建库以来至2022年9月的所有相关文献,经过文献筛查和数据提取之后,最终纳入8篇文献进行统计分析.结果:经过Q检验,得出I²=43%<50%,P>0.1,选用固定效应模型并计算出RR =0.48,95%CI(0.37～0.62),差异具有统计学意义(Z=5.51,P<0.000 01),即倾斜训练可以有效预防血管迷走性晕厥患者的复发.同理,我们还用相同方法研究了直立倾斜试验(HUTT)阳性和倾斜训练过程中可能发生的不良反应这两个指标,但结果提示差异并不具统计学意义[RR=0.63,95%CI(0.25～1.59)(Z=0.98,P=0.33>0.05)和RR=1.70,95%CI(0.45～6.36)(Z=0.78,P=0.43>0.05)].结论:患者经过倾斜训练可以预防血管迷走性晕厥的复发,但现有证据尚无法认为倾斜训练能降低患者后续随访复查直立倾斜试验的阳性率,也无法认为训练过程中会增加不良反应.
Abstract
Objective:To evaluate tilt training for patients with vasovagal syncope(VVS)in terms of its effi-cacy and safety.Methods:We searched all relevant literature in major databases based on the defined search strategy terms from inception to September 2022,after study selection and data extraction,8 studies were included to perform the risk bias assessment and statistical analysis.Results:After the Q test(I²=43%<50%,P=0.120>0.1),we adopted the fixed-effect model and figured out its RR= 0.48,95%CI(0.37-0.62)with statistically significant(Z=5.51,P<0.000 01),which means that tilt training could effectively prevent patients with vasovagal syncope from recurring.Similarly,We also analyzed head-up tilt testing positive results,HUTT(+),and possible adverse reactions,however,neither of them reached the statistical difference(RR=0.63,95%CI[0.25-1.59],Z=0.98,P=0.33>0.05;and RR=1.70,95%CI[0.45-6.36],Z=0.78,P=0.43>0.05,respectively).Conclu-sion:Tilt training can prevent patients with vasovagal syncope from recurring.
关键词
血管迷走性晕厥/倾斜训练/随机对照试验/Meta分析Key words
Vasovagal Syncope/Tilt Training/Randomized Controlled Trial/Systematic Re-view引用本文复制引用
基金项目
国家自然科学基金资助项目(82070348)
出版年
2024
NETL
NSTL
万方数据