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    阿托伐他汀联合曲美他嗪治疗慢性心衰患者临床疗效的meta分析

    Clinical effectiveness of atorvastatin combined with trimetazidine in the treatment of chronic heart failure patients: a meta analysis

    • 摘要: 目的 系统性评价阿托伐他汀联合曲美他嗪与单独使用阿托伐他汀治疗慢性心衰患者的有效性。方法 以PubMed和中国生物医学文献数据库等国内外数据库为数据源,设定曲美他嗪(trimetazidine)、阿托伐他汀(atorvastatin)、心力衰竭(heart failure)为主要的中英文关键词,编制检索策略。根据所设定的纳入和排除标准纳入相关文献,检索时限定为数据库开始建立直至2019年10月,提取数据后采用R软件meta分析包对所纳入的数据进行分析。结果 本次meta分析最终纳入13个研究,共计患者1 265例。结果显示,与单用阿托伐他汀(对照组)比较,阿托伐他汀联合曲美他嗪(试验组)治疗慢性心衰后的临床总有效率更高RR 1.20,95%CI(1.13,1.28),P<0.001;增加左室射血分数(LVEF)SMD =1.67,95%CI (1.23,2.11),P <0.001,减少左室舒张末期内径(LVEDD)SMD =-1.13,95%CI (-1.42,-0.83), P<0.001及左室收缩末期内径(LVESD)更显著SMD =-1.80,95%CI (-2.04,-1.55), P<0.001;增加6 min运动距离SMD =1.14,95%CI (0.98,1.30), P<0.001;降低血浆脑尿钠肽(BNP)SMD =-1.35,95%CI(-1.71,-1.00), P<0.001。结论 阿托伐他汀联合曲美他嗪加常规治疗较单用阿托伐他汀能够更好地提高心衰患者临床总有效率,改善心功能指标。

       

      Abstract: Objective To systematically evaluate the effectiveness of atorvastatin combined with trimetazidine and atorvastatin alone in the treatment of patients with chronic heart failure. Methods Domestic and oversea databases such as PubMed and China Biomedical Literature Database were used and trimetazidine, atorvastatin and heart failure were chose as the main keywords. According to the inclusion and exclusion criteria, relevant literature was included. The search limits were set from database establishment until October 2019. After the data was extracted, the R test meta analysis package was used to perform meta-analysis on the included test data. Results This meta-analysis finally included 13 studies with a total of 1 265 patients. The results showed that, compared with the control group, the group of atorvastatin combined with trimetazidine could improve clinical effectiveness RR 1.20, 95%CI (1.13, 1.28), P<0.001, increase left ventricular ejection fraction (LVEF)SMD = 1.67, 95%CI (1.23, 2.11), P<0.001, reduce left ventricular end-diastolic dimension (LVEFD)SMD = -1.13, 95%CI (-1.42, -0.83), P<0.001, reduce left ventricular end systolic diameter (LVESD)SMD =-1.80, 95%CI (-2.04, -1.55), P<0.001, increase 6 min movement distance SMD = 1.14, 95%CI (0.98, 1.30), P<0.001, and reduce the level of brain natriuretic peptide (BNP)SMD = -1.35, 95%CI (-1.71, -1.00), P<0.001. Conclusions Compared with atorvastatin alone, the combined use of atorvastatin and trimetazidine plus conventional therapy can improve the overall clinical effectiveness of heart failure patients and improve cardiac function indicators.

       

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