摘要
目的系统评价沙库巴曲缬沙坦治疗老年慢性心力衰竭(CHF)病人的有效性和安全性。方法采用计算机检索中国期刊全文数据库(CNKI)、维普中文科技期刊全文数据库(VIP)、中国生物医学文献数据库(CBM)、万方医学数据库、PubMed文献,搜集关于沙库巴曲缬沙坦治疗老年CHF疗效的随机对照试验(RCT),并对文献进行筛选和数据提取,采用RevMan 5.3软件进行Meta分析。结果纳入12项RCT研究,共1299例病人。Meta分析结果显示,沙库巴曲缬沙坦治疗老年CHF(试验组)的效果优于单纯基础治疗(对照组)(RR=1.23,95%CI:1.18~1.30)。同时,治疗后试验组的LVEF(MD=6.16,95%CI:5.66~6.55)、N末端B型利钠肽原(MD=-363.44,95%CI:-397.35~-329.53)、左心室舒张末期内径(MD=-4.58,95%CI:-6.10~-3.06)、6 min步行距离(MD=57.3,95%CI:23.76~90.84)均优于对照组。12篇文献中有8篇对不良反应进行了报道,结果显示,试验组病人的不良反应发生率与对照组相比差异无统计学意义(RR=0.87,95%CI:0.63~1.20)。结论老年CHF病人使用沙库巴曲缬沙坦可显著改善临床疗效及心功能指标,且未增加不良反应发生率。
Objective To systematically evaluate the efficacy and safety of sacubitril valsartan in the treatment of chronic heart failure(CHF)in the elderly patients.Methods The related literatures were retrievaled in the databases such as Chinese National Knowledge Infrastructure(CNKI),VIP,China Biology Medicine(CBM),Wanfang database and PubMed.Randomized controlled trials(RCTs)about the efficacy of sacubitril valsartan in the treatment of CHF in the elderly patients were collected.The retrieved literatures were screened and the data were extracted.Meta-analysis was performed by using RevMan 5.3 software.Results A total of 1299 patients from 12 RCTs were enrolled.The results showed that the efficacy of sacubitril valsartan in the treatment of the elderly patients with CHF(experiment group)was better than basic treatment alone(control group)(RR=1.23,95%CI:1.18-1.30).Meanwhile,the left ventricular ejection fraction(MD=6.16,95%CI:5.66-6.55),N-terminal pro B-type natriuretic peptide(MD=-363.44,95%CI:-397.35--329.53),left ventricular end-diastolic dimension(MD=-4.58,95%CI:-6.10--3.06)and 6-minute walk distance(MD=57.3,95%CI:23.76-90.84)in experiment group were more significantly improved than those in the control group.The incidence of adverse reactions was reported in 8 out of 12 articles.The results showed that there was no significant difference in the incidence rate of adverse reactions between the two groups(RR=0.87,95%CI:0.63-1.20).Conclusions The treatment of sacubitril valsartan in the elderly patients with CHF can significantly improve the clinical efficacy and cardiac function,while the incidence of adverse reactions is not increased.
作者
李善淑
吕逸宁
宫慧敏
张改改
LI Shan-shu;LYU Yi-ning;GONG Hui-min;ZHANG Gai-gai(Department of Geriatrics,the First Affiliated Hospital of Tsinghua University,Beijing 100016,China)
出处
《实用老年医学》
CAS
2023年第10期1023-1026,共4页
Practical Geriatrics
