论文部分内容阅读
目的系统评价厄贝沙坦联合胺碘酮与单用胺碘酮比较治疗阵发性房颤中的效果。方法计算机检索Pub Med、CENTRAL、EMbase、VIP、CNKI和Wan Fang Data数据库,搜集厄贝沙坦联合胺碘酮与单用胺碘酮比较治疗阵发性房颤的相关随机对照试验(RCT),检索时限为2000年到2014年。由2位评价员独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用Rev Man 5.2软件进行Meta分析。结果共纳入9个RCT,998例患者。Meta分析结果显示:在治疗12个月后,厄贝沙坦联合胺碘酮组的左房内经明显小于单用胺碘酮组[MD=–1.49,95%CI(–1.82,–1.15),P<0.000 01],而窦性心律维持率明显高于单用胺碘酮组[OR=3.02,95%CI(2.21,4.11),P<0.000 01],且差异均有统计学意义。结论现有证据显示,厄贝沙坦联合胺碘酮治疗阵发性房颤,可延缓患者左心房内径扩大,维持窦性心率,疗效优于单用胺碘酮治疗。受纳入研究数量和质量所限,上述结论尚需开展更多高质量研究予以验证。
Objective To evaluate the efficacy of irbesartan in combination with amiodarone in the treatment of paroxysmal atrial fibrillation. Methods The databases of Pub Med, CENTRAL, EMbase, VIP, CNKI and Wan Fang Data were searched by computer. A randomized controlled trial (RCT) comparing irbesartan with amiodarone and amiodarone in the treatment of paroxysmal atrial fibrillation was collected. The search period is from 2000 to 2014. After two reviewers independently screened the literature, extracted the data, and assessed the risk of being included in the study, Meta-analysis was performed using Rev Man 5.2 software. Results Nine RCTs and 998 patients were included. The results of Meta analysis showed that the left atria of irbesartan group and amiodarone group were significantly lower than those of the single amiodarone group after 12 months of treatment (MD = -1.49,95% CI -1.82, -1.15) P <0.000 01]. The maintenance rate of sinus rhythm was significantly higher than that of the single amiodarone group [OR = 3.02, 95% CI (2.21, 4.11), P <0.000 01]. The difference was statistically significant. Conclusion The available evidence shows that Irbesartan combined with amiodarone in the treatment of paroxysmal atrial fibrillation can delay the patient’s left atrial diameter expansion, to maintain sinus heart rate, the effect is superior to single amiodarone alone. Due to the limited number and quality of studies involved, the above conclusion still needs to be verified by more high-quality studies.