伊伐布雷定对慢性阻塞性肺疾病合并心血管疾病心肺功能影响的系统评价

齐海军; 张安臣; 杨飞燕; 邱爽; 周长治; 吴嫣然

doi:10.13201/j.issn.1001-1439.2020.08.012

伊伐布雷定对慢性阻塞性肺疾病合并心血管疾病心肺功能影响的系统评价

- 1. 华中科技大学同济医学院附属武汉市中心医院心内科(武汉, 430014);
- 2. 华中科技大学同济医学院附属武汉市中心医院呼吸科;
- 3. 华中科技大学同济医学院附属同济医院中医科
基金项目:
国家自然科学基金项目(No:8180061018)

详细信息

通讯作者: 吴嫣然,E-mail:wuyanran196512@163.com

中图分类号: R54

收稿日期: 2020-03-31

The effect of ivabradine on cardiopulmonary function in chronic obstructive pulmonary disease complicated with cardiovascular disease: a Meta-analysis

- 1. Department of Cardiology;
- 2. Department of Respiratory, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430014, China;
- 3. Department of Traditional Chinese Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology

More Information

Corresponding author: WU Yanran, E-mail: wuyanran196512@163.com

Received Date: 31 March 2020

摘要

摘要: 目的:系统评价伊伐布雷定对慢性阻塞性肺疾病(COPD)合并心血管疾病患者心肺功能的影响及安全性。方法:计算机检索PubMed、MEDLINE、Elsevier ScienceDirect、Cochrane Library、中国知网、万方数据库,收集2005年1月-2020年1月发表的有关伊伐布雷定在COPD合并心血管疾病中应用的随机对照研究文献,应用RevMan5.3软件、Stata12.0软件进行数据统计分析。结果:最终纳入12篇文献,包括756例患者。系统评价结果显示,与对照组比较,伊伐布雷定组在控制心率(WMD=-15,95%CI:-19.47~-11.11,P<0.05)、提高6 min步行距离(6MWD)(WMD=61.25,95%CI:45.8~76.69,P<0.05)、改善Borg呼吸困难评分(WMD=-0.68,95%CI:-0.93~-0.43,P<0.05)、降低COPD合并心力衰竭的N末端脑钠肽前体(NT-proBNP)水平(SMD=-2.18,95%CI:-3.57~-0.79,P<0.05)、减少COPD合并冠心病的心绞痛发作次数(WMD=-1.78,95%CI:-2.21~-1.35,P<0.05)方面差异均有统计学意义;同时不影响患者肺功能第1秒用力呼气容积(FEV1)(WMD=-0.04,95%CI:-0.15~0.07,P=0.52)、第1秒用力呼气容积占预计值百分比(FEVl%预计值)(WMD=1.62,95%CI:-3.23~6.47,P=0.51)、第1秒用力呼气容积占用力肺活量比值(FEVl/FVC)(WMD=2.09,95%CI:-3.53~7.72,P=0.47)。与对照组比较,伊伐布雷定组不良反应发生率无明显统计学差异(RD=0.01,95%CI:-0.00~0.02,P=0.19),包括心动过缓(RD=0.03,95%CI:-0.01~0.08,P=0.13)、心房颤动(RD=0.00,95%CI:-0.03~0.03,P=0.97)、头晕头痛(RD=0.00,95%CI:-0.03~0.04,P=0.98)、视觉症状(RD=0.02,95%CI:-0.01~0.06,P=0.22)。结论:伊伐布雷定在COPD合并心血管疾病中疗效肯定,安全性高,值得临床推广。
- 伊伐布雷定 /
- 慢性阻塞性肺疾病 /
- 心肺功能 /
- 不良反应 /
- Meta分析
Abstract: Objective: To analyze the effect and safety of ivabradine on cardiopulmonary function in chronic obstructive pulmonary disease(COPD) with cardiovascular disease.Method: PubMed,MEDLINE,Elsevier ScienceDirect,Cochrane Library,CNKI and Wanfang database were searched to collect randomized controlled studies on the application of ivabradine in COPD complicated with cardiovascular diseases published from January 2005 to January 2020. RevMan5.3 software and Stata12.0 software were used for statistical analysis of the data.Result: A total of 12 articles with 756 patients were included in this Meta-analysis.The results showed that there were statistically significant differences between the ivabradine group and the control group in lowering heart rate(WMD=-15,95%CI:-19.47--11.11,P<0.05),increasing 6 minute walking distance(6 MWD)(WMD=61.25,95%CI:45.8-76.69,P<0.05),and improving Borg dyspnea score(WMD=-0.68,95%CI:-0.93--0.43,P<0.05),reducing the level of NT-proBNP in COPD patients with heart failure(SMD=-2.18,95%CI:-3.57--0.79,P<0.05),and reducing the number of angina in COPD patients with coronary heart disease(WMD =-1.78,95%CI:-2.21--1.35,P<0.05).At the same time,FEV1(WMD=-0.04,95%CI:-0.15-0.07,P=0.52),FEV1% predicted value(WMD=1.62,95%CI:-3.23-6.47,P=0.51),and FEV1/FVC(WMD =2.09,95%CI:-3.53-7.72,P=0.47)were not affected.Compared with the control group,there was no significant statistical difference in the incidence of adverse reactions in the ivabradine group(RD=0.01,95%CI:-0.00-0.02,P=0.19),including bradycardia(RD=0.03,95%CI:-0.01-0.08,P=0.13),atrial fibrillation(RD=0.00,95%CI:-0.03-0.03,P=0.97),dizziness and headache(RD=0.00,95%CI:-0.03-0.04,P=0.98),and visual symptoms(RD=0.02,95%CI:-0.01-0.06,P=0.22).Conclusion: Ivabradine has positive efficacy and high safety in COPD patients with cardiovascular diseases,worthy of clinical promotion.
- ivabradine /
- chronic obstructive pulmonary disease /
- cardiopulmonary-function /
- Meta analysis /

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