芪苈强心治疗慢性心力衰竭的meta分析
Meta-analysis of Qiliqiangxin in the treatment of chronic heart failure
毛天诗 1李宇轩 1庞彦廷 1王佟 1曲信彦 1林谦1
作者信息
- 1. 北京中医药大学东直门医院(北京,100700)
- 折叠
摘要
目的:通过meta分析评价芪苈强心(QLQX)对慢性心力衰竭(心衰)患者远期预后及临床疗效的影响.方法:计算机检索PubMed、Cochrane Library、Web of Science、中国知网、万方及维普6大数据库,检索时限为建库起至2024年9月.对符合纳排标准的文献提取指标数据,采用RevMan 5.4及StataMP 64软件进行统计学分析.结果:共纳入25篇随机对照临床试验,总计6 541例患者.Meta分析结果显示,在临床预后方面,常规抗心衰治疗方案联合QLQX可显著降低心血管死亡率(RR=0.83,95％CI 0.70～0.98,P=0.03)、心衰再入院率(RR=0.82,95％CI 0.72～0.94,P=0.004)、全因死亡率(RR=0.84,95％CI 0.72～0.99,P=0.03)及复合心血管事件风险(RR=0.82,95％CI 0.73～0.92,P=0.0005).此外,QLQX能提高左室射血分数(MD=6.04,95％CI 4.52～7.56,P＜0.001)、减小左室舒张末期内径(MD=-3.66,95％CI-5.15～-2.16,P＜0.001)、降低N末端脑钠肽前体水平(MD=-276.78,95％CI-349.53～-204.02,P＜0.001)、改善NYHA心功能分级(RR=2.10,95％CI 1.70～2.58,P＜0.001)、提高 6 分钟步行试验距离(MD=51.27,95％CI 39.11～63.43,P＜0.001)及降低明尼苏达州心衰患者生活质量量表评分(MD=-8.97,95％CI-11.37～-6.58,P＜0.001).尽管部分指标存在显著异质性,但敏感性分析支持结果的稳健性.结论:QLQX联合常规治疗能进一步降低慢性心衰患者的心血管死亡、心衰再入院及全因死亡风险,改善远期预后.此外,QLQX在改善心功能及心室重构、提高运动耐量、改善生活质量方面也显示出潜在益处.
Abstract
Objective:To evaluate the clinical efficacy and long-term prognosis of Qiliqiangxin(QLQX)in pa-tients with chronic heart failure(CHF)by meta-analysis.Methods:PubMed,Cochrane Library,Web of Science,CNKI,Wanfang,and VIP databases were searched from inception to September 2024.The RevMan 5.4 and StataMP 64 software were used for statistical analysis.Results:A total of 25 randomized controlled trials invol-ving 6541 patients were included.Meta-analysis results showed that in terms of hard endpoint events,QLQX sig-nificantly reduced cardiovascular mortality(RR=0.83,95％CI0.70 to 0.98,P=0.03),rehospitalization for HF(RR=0.82,95％CI0.72 to 0.94,P=0.004),and all-cause mortality(RR=0.84,95％CI0.72 to 0.99,P=0.03)and composite cardiovascular events(RR=0.82,95％CI0.73 to 0.92,P=0.0005).In addition,QLQX improved LVEF(MD=6.04,95％CI4.52 to 7.56,P＜0.001),reduced LVEDd(MD=-3.66,95％CI-5.15 to-2.16,P＜0.001),decreased NT-proBNP level(MD=-276.78,95％CJ-349.53 to-204.02,P＜0.001),improved NYHA class(RR=2.10,95％CI1.70 to 2.58,P＜0.001),increased 6MWD(MD=51.27,95％CI39.11 to 63.43,P＜0.001)and decreased ML HFQ score(MD=-8.97,95％CI-11.37 to-6.58,P＜0.001).Although there were significant heterogeneity for some outcomes,sensitivity analyses supported the ro-bustness of the results.Conclusion:QLQX combined with conventional therapy can further reduce the risks of cardiovascular death,rehospitalization for HF or all-cause death and improve the long-term prognosis of CHF pa-tients.In addition,QLQX also showed potential benefits in improving cardiac function,ventricular remodeling,exercise tolerance,and quality of life.
关键词
芪苈强心/慢性心力衰竭/临床预后/meta分析Key words
qiliqiangxin/chronic heart failure/clinical prognosis/meta analysis引用本文复制引用
出版年
2024
NETL
NSTL
万方数据