左西孟旦用于严重脓毒血症和脓毒性休克并发心力衰竭患者的Meta分析

发布时间：2018-07-09 12:54

本文选题：左西孟旦 + 心力衰竭　；参考：《中华医院感染学杂志》2017年24期

【摘要】：目的评价与标准强心剂(多巴酚丁胺类药物)对比,左西孟旦能否取得令临床满意的治疗效果。方法检索2005年1月-2015年12月CNKI、CBM、VIP、万方数据、BioMedCentral、Embase、Pubmed、Central中符合条件的文献;左西孟旦应用于严重脓毒血症和脓毒性休克并发心衰患者且有病死率描述的随机对照试验将被纳入;本研究首要结果是病死率,次要指标为心排血指数(CI)、血清乳酸浓度(LAC)、左心室射血分数(LVEF)、左心室每搏作功指数(LVSWI)、平均动脉压(MAP)。结果共411例患者的11项研究被纳入到本次分析;左西孟旦组病死率为36.8%(77/209),对照组病死率为47.5%(96/202),RR=0.77[0.62,0.95],P=0.02,同质性检验P=0.98,I2=0%;与对照组相比,CI、LVEF、LVSWI升高,LAC降低,MAP差异无统计学意义。结论在严重脓毒血症和脓毒性休克患者中,左西孟旦与标准强心剂治疗相比,可降低病死率。本结论需进行大型多中心随机对照试验验证。
[Abstract]:Objective to evaluate the clinical efficacy of levosimendan in comparison with standard cardiopressin (dobutamine). Methods from January 2005 to December 2015, CNKI CBMN VIPs were searched for the eligible literature in BioMedCental Embase Pubmedus Central, and a randomized controlled trial with mortality description for patients with severe sepsis and septic shock complicated with heart failure was included in the randomized controlled trial of levsimendan applied to patients with severe sepsis and septic shock complicated with heart failure. The primary results of this study were mortality. The secondary indexes were cardiac output index (CI), serum lactate concentration (LAC), left ventricular ejection fraction (LVEF), left ventricular stroke work index (LVSWI) and mean arterial pressure (map). Results 11 studies of 411 patients were included in this analysis. The mortality of patients in levosimendan group was 36.8% (77 / 209), and that in control group was 47.5% (96 / 202). The mortality rate of control group was 47.5% (96 / 202). Conclusion in patients with severe sepsis and septic shock, levosimendan can reduce mortality compared with standard cardioplegic therapy. This conclusion needs to be verified by large-scale multi-center randomized controlled trial.
【作者单位】：胜利油田中心医院药学部;胜利油田中心医院重症医学科;
【分类号】：R459.7;R541.6

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