曲美他嗪治疗稳定型心绞痛疗效与安全性的系统评价

发布时间：2018-10-20 13:57

【摘要】：目的系统评价曲美他嗪(Trimetazidine,TMZ)治疗稳定型心绞痛(stable angina pectoris,SAP)的临床疗效和安全性。方法计算机检索CBM(1989～2011.6)、CNKI(1997～2011.6)、WanFang Data(1989～2011.6)、MEDLINE(1966～2011.6)、EMbase(1974～2011.6)和Cochrane对照试验资料库(1989～2011.6)中有关曲美他嗪治疗稳定型心绞痛的随机对照试验(RCT),按纳入与排除标准选择文献并进行资料提取和质量评价后,采用RevMan 5.0软件进行Meta分析。结果共纳入15个RCT,1 500例患者。Meta分析结果显示:在平板/踏车试验ST段压低1 mm阈值[WMD=0.84,95%(0.74,0.93),P0.000 01]、运动持续时间[WMD=0.82,95%(0.73,0.91),P0.000 01]、心绞痛发作阈值[WMD=1.18,95%(0.87,1.50),P0.000 01]、每周心绞痛发作次数[WMD= 1.79,95%( 1.93, 1.66),P0.000 01]和每周硝酸甘油消耗量[WMD= 0.60,95%( 0.74, 0.46),P0.000 01]五个方面,曲美他嗪组均明显优于对照组;而在副反应方面,曲美他嗪组与对照组的差异无统计学意义[RR=0.83,95%CI(0.52,1.32),P=0.42]。结论曲美他嗪治疗稳定型心绞痛疗效优于对照药物,而副反应与对照药物无明显差别,疗效确切,安全性较好。受纳入文献的质量限制及可能存在的发表偏倚影响,本Meta分析结论尚需开展更多高质量、大样本、多中心、随机双盲对照试验加以证实。
[Abstract]:Objective to evaluate the efficacy and safety of trimetazidine (Trimetazidine,TMZ) in the treatment of stable angina pectoris (stable angina pectoris,SAP). Methods CBM (1989 / 2011.6), CNKI (1997 / 2011.6), WanFang Data (1989/ 2011.6), MEDLINE (1966/ 2011.6), EMbase (1974 / 2011.6) and Cochrane controlled trial database (1989/ 2011.6) were used to search the literature of randomized controlled trial (RCT),) of trimetazidine in the treatment of stable angina pectoris according to inclusion and exclusion criteria. After material extraction and quality evaluation, Meta analysis was carried out with RevMan 5.0 software. Results A total of 15 RCT,1 patients were included. The results of Meta analysis showed that 1 mm threshold was depressed in the ST segment of the flat / treadmill test [WMD=0.84,95% (0.74 卤0.93), P 0.00001], exercise duration [WMD=0.82,95% (0.733 卤0.91), P 0.00001], angina threshold [WMD=1.18,95% (0.871.50), P0.00001], weekly angina pectoris attack times [WMD= 1.79 95% (1.93, 1.66), P0.00001] and Nitroglycerin consumption per week [WMD= 0.60g 95% (0.74, 0.46), P0.00001], The trimetazidine group was significantly better than the control group, but there was no significant difference between the trimetazidine group and the control group in side effects [RR=0.83,95%CI (0. 52 卤1. 32), P < 0. 42]. Conclusion the efficacy of trimetazidine in the treatment of stable angina pectoris is better than that of the control group, but the side effects are not significantly different from those of the control drugs. Due to the quality limitation of the literature and the possible bias of publication, the conclusion of this Meta analysis needs to be confirmed by more high quality, large sample, multi-center, randomized double-blind controlled trials.
【作者单位】：新疆医科大学第一附属医院心脏病中心冠心病一科;新疆医科大学第一附属医院风湿免疫科;承德市中心医院内分泌科;
【基金】：新疆维吾尔自治区自然科学基金(编号:2010211A44)
【分类号】：R541.4

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