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目的评价选择性五羟色胺再摄取抑制剂(SSRIs)舍曲林对冠心病合并抑郁患者的死亡率、心肌梗死(以下简称心梗)再发率、射血分数、心率变异性(SDNN、RMSSD、LF/HF、Ln LF、Ln HF)的影响。方法计算机检索Medline、Web of Sci-ence、Pub med、Cochtane Central Register of Controlled Trials(CENTRAL)、中国生物医学文献数据库、中国期刊全文数据库中关于冠心病、心肌梗死、抑郁和SSRIs舍曲林的随机对照试验,同时筛检纳入文献的的参考文献。对文献质量进行严格评价和资料提取,对符合质量标准的随机对照试验(RCT)进行系统评价(Meta)分析。结果检索到11篇相关文献,其中英文7篇,中文4篇。研究表明舍曲林对冠心病合并抑郁患者的死亡率OR值为0.56(95%CI为0.42~0.75,P<0.01)、再发心肌梗死率OR为0.72(95%CI为0.52~0.98,P<0.05),射血分数的加权均数差为3.43(95%CI为0.46~6.41,P<0.05),LnHF的加权均数差为-0.21(95%CI为-0.39~-0.03,P<0.05),与安慰剂相比有显著差别。结论冠心病合并抑郁患者服用SSRIs舍曲林有积极的治疗作用。
Objective To evaluate the effects of sertraline, a selective serotonin reuptake inhibitor (SSRIs), on mortality, myocardial infarction (MI) recurrence rate, ejection fraction and heart rate variability (SDNN, RMSSD, LF / HF, Ln LF, Ln HF). Methods The computer-aided search of randomized controlled trials on coronary heart disease, myocardial infarction, depression and SSRIs sertraline in Medline, Web of Sci-ence, Pub med, Cochtane Central Register of Controlled Trials (CENTRAL), Chinese Biomedical Literature Database, Chinese Journal Full- Controlled trials, while screening references for inclusion in the literature. A rigorous evaluation of the quality of the literature and data extraction were performed and a meta-analysis of meta-analyzes was performed on randomized controlled trials (RCTs) that met the quality criteria. Results There were 11 related articles retrieved, including 7 in English and 4 in Chinese. The study showed that the OR of sertraline in patients with coronary heart disease and depression was 0.56 (95% CI 0.42-0.75, P <0.01). The OR of recurrent myocardial infarction was 0.72 (95% CI 0.52-0.98, P <0.05). The weighted mean difference of ejection fraction was 3.43 (95% CI 0.46-6.41, P <0.05). The weighted mean difference of LnHF was -0.21 (95% CI -0.39 -0.03, P < 0.05), compared with placebo there are significant differences. Conclusion SSRIs sertraline has a positive therapeutic effect in patients with coronary heart disease and depression.