摘要
目的评价β受体阻滞剂阿替洛尔注射液在急性冠脉综合征(ACS)早期治疗中的作用效果。方法计算机检索Cochrane图书馆、Pubmed、Embase、Highwire、Medline、CBM、CNKI、CSJD等中外生物医学数据库,收集关于阿替洛尔注射液在ACS治疗中早期应用的随机对照试验。按Cochrane系统评价方法,评价所纳入研究的文献质量,并提取有效数据,采用RevMan 5.0软件进行Meta分析。结果共纳入6项研究,共计26 658例患者。Meta分析结果显示,阿替洛尔注射液治疗组与对照组相比,ACS患者的死亡率明显降低(RR=0.84,95%CI 0.73～0.96,P=0.01);室性快速性心律失常发生明显减少(RR=0.62,95%CI 0.42～0.91,P=0.01);患者再次心肌梗死的发生率明显减少(RR=0.54,95%CI0.32～0.92,P=0.02);心源性休克发生率差异无统计学意义(RR=0.16,95%CI 0.22～1.28,P=0.16),表明阿替洛尔注射液并不增加心源性休克的风险,且可显著降低卒中发生风险(RR=0.70,95%CI 0.58～0.84,P=0.0001)。结论 ACS治疗中应用阿替洛尔注射液治疗可明显减少室性快速性心律失常的发生,从而降低患者死亡率,改善患者预后。
Objective To assess the efficacy of intravenous beta-blocker atenolol for acute coronary syndrome （ACS）. Methods Electronic databases including Cochrane library, Pubmed, Embase, Highwire, Medline, CBM, CNKI and CSJD were searched. A meta-analysis of all randomized controlled trials （RCTs） comparing atenolol with control in ACS therapy was performed. Study selection and meta-analysis were conducted according to the Cochrane Handbook for systematic reviews. Data were extracted from these trials by 3 reviewers independently and analyzed by RevMan 5.0 software. Results A total of 6 RCTs including 26 658 patients were assessed in this study. Compared with control group, the mortality （RR=0.84, 95%CI 0.73-0.96, P=0.01）, ventricular tachyarrhythmias （RR=0.62, 95%CI 0.42-0.91, P=0.01）, and incidence of reinfarction after myocardial infarction （RR=O.54, 95%CI 0.32-0.92, P=0.02） in intravenous atenolol group were decreased significantly. No difference was found in the incidence of cardiogenic shock （RR=0.16, 95%CI 0.22-1.28, P=0.16）. Furthermore, intravenous atenolol significantly decreased the occurrence of stroke （RR=0.70, 95%CI 0.58-0.84, P=0.0 001）. Conclusion Intravenous atenolol as used in ACS therapy could decrease the incidence ofventricular tachyarrhythmias and mortality, thereby improving the prognosis of ACS patients.
出处
《解放军医学杂志》
CAS
CSCD
北大核心
2014年第1期35-39,共5页
Medical Journal of Chinese People's Liberation Army
