摘要
目的系统评价他汀类药物联合胺碘酮与单用胺碘酮治疗心房颤动(房颤)的临床疗效。方法检索CNKI、万方、CBM、维普、PubMed、EMbase、Clinical Trials、Cochrane临床对照试验数据库,全面收集他汀类药物联合胺碘酮治疗房颤的随机对照试验,按纳入和排除标准由2名评价者独立选择文献、提取资料,交叉核对并进行方法学质量评估,采用RevMan 5.3软件进行统计分析。结果共纳入38个随机对照试验,共3773例受试者。Meta分析结果显示:他汀类药物联合胺碘酮(他汀类药物组)组与单用胺碘酮(对照组)治疗房颤比较,他汀类药物组房颤复发率(21.02%)低于对照组(41.11%,RR=0.51,95%CI:0.45~0.58,P<0.00001),他汀类药物组治疗后左房内径(LAD)小于对照组(MD=-3.20,95%CI:-4.15^-2.25,P<0.00001),C反应蛋白(CRP)小于对照组(MD=-1.88,95%CI:-2.32^-1.43,P<0.0001)。他汀类药物组不良反应发生率(7.00%)较对照组(3.93%)高(RR=1.73,95%CI:1.11~2.71,P=0.02)。结论他汀类药物联合胺碘酮对治疗房颤有较好疗效。由于本系统评价纳入研究样本质量较低,增加了本次系统评价结论产生偏倚的风险,因此他汀类药物联合胺碘酮治疗房颤的疗效和安全性需要更多高质量临床试验加以证实。
Objective To review systematically the clinical efficacy of statins combined with amiodarone and amiodarone alone in treatment of atrial fibrillation(AF).Methods The databases of CNKI,WanFang Data,CBM,VIP,PubMed,EMbase,Clinical Trials and CENTRAL were retrieved for collecting randomized controlled trials(RCT)on statins combined with amiodarone for treating AF.The literature was selected and data was extracted by 2 reviewers independently according to inclusion and exclusion criteria,and literature was checked crossly,given methodological quality evaluation and analyzed statistically by using RevMan 5.3 software.Results There were totally 38 RCT included involved 3773 subjects.The results of Meta-analysis showed that AF recurrent rate was lower in statins group(21.02%)than that in control group(41.11%,RR=0.51,95%CI:0.45~0.58,P<0.00001).LAD was lower(MD=-3.20,95%CI:-4.15^-2.25,P<0.00001)and CRP was lower(MD=-1.88,95%CI:-2.32^-1.43,P<0.0001)in statins group than those in control group.The incidence rate of adverse reactions was higher in statins group(7.00%)than that in control group(3.93%,RR=1.73,95%CI:1.11~2.71,P=0.02).Conclusion Statins combined with amiodarone has better curative effect on AF.The conclusion has the risk of bias due to lower quality of included RCT,so the curative effect and safety of statins combined with amiodarone in AF treatment need to be confirmed further with more high-quality clinical trials.
作者
贾秋蕾
石晶晶
胡元会
石树青
褚瑜光
魏艺
Jia Qiulei;Shi Jingjing;Hu Yuanhui;Shi Shuqing;Chu Yuguang;Wei Yi(Beijing University of Chinese Medicine,Beijing 100029,China;不详)
出处
《中国循证心血管医学杂志》
2020年第7期805-812,共8页
Chinese Journal of Evidence-Based Cardiovascular Medicine
基金
北京市自然科学基金(7172188)。
关键词
他汀
胺碘酮
心房颤动
Meta分析
Statins
Amiodarone
Atrial fibrillation
Meta-analysis
