静脉注射地尔硫卓、美托洛尔控制房颤快速心室率疗效和安全性比较的Meta分析

发布时间：2018-08-17 18:26

【摘要】：目的比较静脉注射地尔硫卓、美托洛尔控制房颤快速心室率疗效和安全性。方法检索Pub Med、EMbase、Cochrane Library、Web of Science、CNKI、VIP、CBM和万方数据库,收集所有比较地尔硫卓、美托洛尔治疗房颤快速心室率的随机对照试验(RCTs),检索时间均为各数据库建库时间至2015年10月。按照纳入和排除标准由2名评价者独立筛选并提取资料,采用Cochrane 5.1手册提供的偏倚风险评估方法,对纳入研究进行质量评价后,使用Rev Man 5.3软件进行Meta分析。结果共纳入6项研究,共366例患者。Meta分析结果显示:1有效性方面:地尔硫卓控制房颤快速心室率与美托洛尔相比总有效率无明显差异[相对危险度(RR)=1.12,95%可信区间(CI):0.96~1.31,P=0.14],房颤心室率下降幅度地尔硫卓组优于美托洛尔组[加权均数差(MD)=10.01,95%CI:3.95~16.07,P=0.001],平均起效时间两者无明显差别(MD=-0.50,95%CI:-1.68~0.67,P=0.40);2安全性方面:不良反应(包括收缩压12.0 k Pa、心室率60次/min)发生率两者相比差异无统计学意义[率差(RD)=-0.00,95%CI:-0.04~0.04,P=0.89]。结论现有研究显示,地尔硫卓与美托洛尔控制房颤快速心室率的总有效率、平均起效时间及安全性方面无差异,但地尔硫卓心室率下降幅度更大。因受纳入研究数量及部分研究质量限制,该结论尚需开展更多大样本、多中心的随机对照试验加以验证。
[Abstract]:Objective to compare the efficacy and safety of intravenous diltiazem and metoprolol in the control of rapid ventricular rate in atrial fibrillation. Methods the Pub Medbase EMbase Cochrane Library Web of Science Pub VIPCMs and Wanfang databases were searched. The (RCTs), retrieval time of all the comparative diltiazem and metoprolol randomized controlled trials for the treatment of atrial fibrillation rapid ventricular rate (RVR) was established from October 2015 to October 2015. According to the inclusion and exclusion criteria, the data were independently screened and extracted by two evaluators. The bias risk assessment method provided by the Cochrane 5.1 manual was used to evaluate the quality of the inclusion study and the Meta analysis was carried out with Rev Man 5.3 software. The results were included in six studies, In a total of 366 patients, the results of Meta-analysis showed that there was no significant difference in the total effective rate between diltiazem and metoprolol in the control of atrial fibrillation. [relative risk (RR) 1.1295% confidence interval (CI): 0.96 卤1.31 P < 0.14], the ventricular rate of atrial fibrillation decreased significantly. The safety of ertiazem group was better than that of metoprolol group [weighted mean difference (MD) 10.01% ~ 95 CI: 3.95% 16.07% P0. 001], and there was no significant difference between the two groups in average onset time (MD-0.50 ~ 95CI- 1.68 ~ 0.67% P0. 40) in terms of safety: adverse reactions (including systolic pressure 12.0 KPA, ventricular rate 60 times / min) had no significant difference between the two groups [the difference was (RD) -95CI- 0.04P0. 89]. Conclusion there is no difference in the total effective rate, mean onset time and safety between diltiazem and metoprolol in the control of rapid ventricular rate in atrial fibrillation. Due to the limitation of the number of studies and the quality of some studies, this conclusion needs to be verified by a multi-center randomized controlled trial.
【作者单位】：安徽医科大学第一附属医院心血管内科;
【基金】：安徽高校自然科学研究项目(编号:KJ2015ZD24)
【分类号】：R541.75

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