Efficacy of levosimendan versus dobutamine in patients with heart failure:a meta-analysis
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摘要: 目的:应用meta分析的统计学方法,探究注射用左西孟旦与多巴酚丁胺对比治疗心力衰竭患者的临床疗效。方法:采用计算机检索Cochrane图书馆临床对照试验资料库、EMbase、MEDLINE检索国外文献,收集有关左西孟旦对比多巴酚丁胺治疗心力衰竭的临床随机试验,对纳入的6篇文献进行质量评价,并应用RevMan5.1软件对数据进行meta分析。结果:6个随机对照试验共997例充血性心力衰竭患者纳入研究,以上所有纳入文献均为多中心国外研究,通过meta分析结果显示:应用左西孟旦对比多巴酚丁胺治疗心力衰竭后,前者在对心力衰竭患者的左心室射血分数、心输出量、心脏指数及高敏C反应蛋白的影响上优于后者,两者间差异有统计学意义。结论:左西孟旦能有效改善心力衰竭患者心功能,效果优于多巴酚丁胺,且前者可能通过抗炎途径发挥心功能改善作用。Abstract: Objective:Using meta-analysis to evaluate the efficacy of levosimendan versus dobutamine in patients with acutly decompensated heart failure.Method:All randomized controlled trials(RCTs) of levosimendan for heart failure were collected from the Cochrane Library and MEDLINE.RevMan 5.1software was used for meta-analysses.Result:A total of 6 RCTs involving 997 patients were enrolled in the meta-analysis.When compared with dobutamine,levosimendan was significantly improved left ventricular ejection fraction(WMD=0.99,95%CI(0.28,1.71),P=0.006,I2=80%),cardiac output(WMD=0.50,95%CI(0.38,0.62),P<0.000 01),cardiac index(WMD=0.79,95%CI(0.74,0.85),P<0.000 01,I2=74%),and high-sensitivity c-reactive protein(WMD=-2.30,95%CI(-3.08,-1.52),P<0.000 01).Conclusion:Levosimendan may be a kind of medicine relatively effective for heart failure.In patients with heart failure,levosimendan improved left ventricular ejection fraction,cardiac output,cardiac index,and high-sensitivity c-reactive proteins more effectively than dobutamine.
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Key words:
- levosimendan /
- dobutamine /
- efficacy /
- meta-analysis
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[1] YOKOSHIKI H,KATSUBE Y,SUNAGAWA M,et al.Levosimendan,a novel Ca2+sensitizer,activates the glibenclamide-sensitive K+channel in rat arterial myocytes[J].Eur J Pharmacol,1997,333:249-259.
[2] NIEMINEN M S,HASENFUSS G,KLEBER F X,et al.Hemodynamic and neurohumoral effects of continuous infusion of levosimendan in patients with congestive heart failure[J].J Am Coll Cardiol,2000,36:1903-1912.
[3] TASAL A,ERTURK M,UYAREL H,et al.Utility of the neutrophil to lymphocyte ratio for predicting in-hospital mortality after levosimendan infusion in patients with acute decompensated heart failure[J].J Cardiol,2014,63:418-423.
[4] SAMIMI-FARD S,GARCIA-GONZALEZ M J,DOMINGUEZ-RODRIGUEZ A,et al.Effects of levosimendan versus dobutamine on long-term survival of patients with cardiogenic shock after primary coronary angioplasty[J].Int J Cardiol,2008,127:284-287.
[5] BERGH C A,DAHLSTRÖM U,FORFANG K,et al.Intravenous levosimendan vs.dobutamine in acute decompensated heart failure patients on beta-blockers[J].Eur J Heart Fail,2010,12:404-410.
[6] LEVIN R D,PORCILE R,SALVAGIO F,et al.The calcium sensitizer levosimendan gives superior results to dobutamine in postoperative low cardiac output syndrome[J].Rev Esp Cardiol,2008,61:471-479.
[7] DUMAN D,PALIT F,SIMSEK E,et al.Effects of levosimendan versus dobutamine on left atrial function in decompensated heart failure[J].Canadian Journal of Cardiology,2009,25:e353-e356.
[8] FOLLATH F,CLELAND J G F,JUST H,et al.Efficacy and safety of intravenous levosimendan compared with dobutamine in severe low-output heart failure(the LIDO study):a randomised double-blind trial[J].The Lancet,2002,360:196-202.
[9] PARISSIS J T,ADAMOPOULOS S,ANTONIADES C,et al.Effects of levosimendan on circulating pro-inflammatory cytokines and soluble apoptosis mediators in patients with decompensated advanced heart failure[J].Am J Cardiol,2004,93:1309-1312.
[10] FARMAKIS D,PARISSIS J T,BISTOLA V,et al.Plasma B-type natriuretic peptide reduction predicts long-term response to levosimendan therapy in acutely decompensated chronic heart failure[J].Int J Cardiol,2010,139:75-79.
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