摘要
目的系统评价胺碘酮联合美托洛尔治疗快速心律失常的疗效和安全性。方法检索PubMed、SCI,Cochrane图书馆、CNKI、万方数据库等所有比较胺碘酮联合美托洛尔(联合组)和单用胺碘酮(胺碘酮组)治疗快速心律失常的随机对照试验(RCT),检索时间为建库至2017年4月。采明Jadad改良法制定的量表进行质量评价,采用ReMan 5.3软件对纳入的研究结果进行Meta分析。结果共纳入9篇文献907例患者。Meta分析结果表明:联合组治疗快速心律失常的总有效率高于胺碘酮组(OR=7.98,95%CI4.64~13.70,P<0.01),治疗后心率低于胺碘酮组(SMD=-22.01,957%CI-27.20^-16.81,P<0.01),收缩压低于胺碘酮组(SMD=-24.23,95%CI-26.04^-22.43,P<0.01),舒张压低于胺碘酮组(SMD=-13.62,95%CI-15.25^-12.00,P<0.01)。治疗后总的不良反应发生率差异无统计学意义(OR=0.83,95%,CI 0.44~1.59,P=0.58)。结论胺碘酮联合美托洛尔可提高快速心律失常治疗的总有效率,治疗后心率、收缩压和舒张压都低于单用胺碘酮。
Objective To evaluate the efficacy and safety of amiodarone combined with metoprolol in the treatment of tachyarrhythmia. Methods Collecting the randomized controlled trials(RCT) about metoprolol and amiodarone alone on the treatment of tachyarrhythmia. The quality evaluation was performed using the scale developed by the Jadad improvement method. The extracted data was analyzed by RevMan 5.3 software. Results The results were included 9 papers according to the standard. The results of meta-analysis showed that the total effective rate of amiodarone combined with metoprolol in the treatment of tachyarrhythmia was higher than that of amiodarone alone( OR = 7. 98, 95% CI 4. 64 to 13. 70, P <0. 01); the heart rate was lower than that of amiodarone alone(SMD =-22.01, 95% Cl-27.20 to-16. 81, P <0.01) and systolic blood pressure after treatment was lower than that of amiodarone alone(SMD =-24.23, 95% CI-26. 04 to-22.43, P <0.01). After treatment, the diastolic blood pressure was lower than that of amiodarone alone group(SMD =-13. 62, 95%CI-15.25 to-12. 00, P <0. 01). There was no significant difference in the overall incidence of adverse reactions after treatmenl( OR = 0.83, 95% CI 0.44 to 1.59, P = 0.58). Conclusion Amiodarone combined with metoprolol group can improve the total effective rate of rapid arrhythmia treatment. After treatment, heart rate, systolic blood pressure and diastolic blood pressure are lower than amiodarone alone group, and it will not increase its toxic and side effects.
出处
《疑难病杂志》
CAS
2017年第11期1141-1144,共4页
Chinese Journal of Difficult and Complicated Cases
基金
湖北省自然科学基金资助项目(2013CFB250)
