[1]沈继龙,王元元,付 婷,等.国内磷酸肌酸钠治疗冠心病心力衰竭的Meta分析[J].医学信息,2019,32(20):67-71,76.[doi:10.3969/j.issn.1006-1959.2019.20.019]
 SHEN Ji-long,WANG Yuan-yuan,FU Ting,et al.Meta-analysis of Sodium Creatine Phosphate in the Treatment of Coronary Heart Disease with Heart Failure in China[J].Journal of Medical Information,2019,32(20):67-71,76.[doi:10.3969/j.issn.1006-1959.2019.20.019]
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国内磷酸肌酸钠治疗冠心病心力衰竭的Meta分析()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
32卷
期数:
2019年20期
页码:
67-71,76
栏目:
论著
出版日期:
2019-10-15

文章信息/Info

Title:
Meta-analysis of Sodium Creatine Phosphate in the Treatment of Coronary Heart Disease with Heart Failure in China
文章编号:
1006-1959(2019)20-0067-06
作者:
沈继龙王元元付 婷周情太汪明灯
(南京医科大学附属苏州科技城医院重症医学科,江苏 苏州 215153)
Author(s):
SHEN Ji-longWANG Yuan-yuanFU TingZHOU Qing-taiWANG Ming-deng
(Department of ICU,Suzhou Science and Technology Hospital,Nanjing Medical University,Suzhou 215153,Jiangsu,China)
关键词:
冠心病心力衰竭Meta分析磷酸肌酸钠
Keywords:
Coronary heart diseaseHeart failureMeta-analysisSodium creatine phosphate
分类号:
R541.4;R541.6
DOI:
10.3969/j.issn.1006-1959.2019.20.019
文献标志码:
A
摘要:
目的 采用Meta分析评价国内磷酸肌酸钠对冠心病心力衰竭的临床疗效。方法 计算机检索中国期刊全文数据库、中国生物医学文献数据库、维普中文期刊及万方数据库中关于磷酸肌酸钠治疗冠心病心力衰竭的研究报道。文献检索时限为建库至2018年12月。采用RevMan5.3软件对纳入的文献数据进行Meta分析。结果 共纳入文献16篇,累计1448例患者。Meta分析结果显示:①总体疗效评价:磷酸肌酸钠组治疗冠心病心力衰竭的临床疗效高于常规治疗组(OR=4.93,95%CI 3.47~7.01,P<0.001);②不同疗程疗效评价:疗程14 d时,磷酸肌酸钠组比常规治疗组能更有效的改善冠心病心力衰竭患者的心脏功能(OR=6.34,95%CI 3.90~10.29,P<0.001);疗程<14 d时,磷酸肌酸钠组改善冠心病心力衰竭患者的心功能与常规治疗组比较,差异不显著(OR=2.57,95%CI 1.29~5.09,P>0.001);疗程>14 d时,磷酸肌酸钠组比常规治疗组能更有效的改善冠心病心力衰竭患者的心脏功能(OR=5.44,95%CI 2.42~12.23,P<0.001)。③剂量疗效评价:对疗程14 d的9项研究根据不同剂量进行亚组分析,剂量为1 g ivgtt qd时,磷酸肌酸钠组改善冠心病心力衰竭患者的心功能与常规治疗组比较,差异不显著(OR=4.87,95%CI 1.7~13.98,P>0.001);剂量为1 g ivgtt bid时,磷酸肌酸钠组比常规治疗组能更有效的改善冠心病心力衰竭患者的心脏功能(OR=9.73,95%CI 4.05~23.40,P<0.001);剂量为2 g ivgtt qd时,磷酸肌酸钠组比常规治疗组能更有效的改善冠心病心力衰竭患者的心脏功能(OR=6.11,95%CI 2.93~12.72,P<0.001);同时1 g bid剂量的改善效果优于2 g bid和1 g qd。结论 磷酸肌酸钠能够缓解冠心病心力衰竭患者临床症状,改善心功能,具有一定的临床疗效,同时磷酸肌酸钠改善冠心病心力衰竭患者心功能的效果与给药剂量和次数有一定的相关性。
Abstract:
Objective Meta-analysis was used to evaluate the clinical efficacy of sodium creatine phosphate in patients with coronary heart disease and heart failure. Methods Computer-researched Chinese Journal Full-text Database, China Biomedical Literature Database, Weipu Chinese Journal and Wanfang Database reported on the treatment of coronary heart disease with heart failure by sodium creatine phosphate. The time limit for document retrieval is to build the library until December 2018. Meta-analysis of the included literature data was performed using RevMan 5.3 software. Results A total of 16 articles were included in the literature, with a total of 1448 patients. Meta-analysis results showed:①Overall efficacy evaluation: The clinical efficacy of sodium creatine phosphate group in the treatment of coronary heart disease with heart failure was significantly higher than that of the conventional treatment group (OR=4.93, 95%CI3.47~7.01, P<0.001); ②Efficacy evaluation of different courses of treatment: At 14 d of treatment, the sodium creatine phosphate group was more effective than the conventional treatment group in improving cardiac function in patients with coronary heart disease (OR=6.34, 95%CI3.90~10.29,P<0.001); When the course of treatment was <14 d, the cardiac function of patients with heart failure in patients with coronary heart disease was significantly different from that of the conventional treatment group (OR=2.57, 95%CI1.29~5.09, P>0.001). When the course of treatment was >14 d, The sodium creatine phosphate group was more effective than the conventional treatment group in improving cardiac function in patients with coronary heart disease (OR=5.44, 95%CI2.42~12.23, P<0.001). ③Evaluation of different doses of efficacy: 9 cases of 14 d of treatment were subgroup analysis according to different doses. When the dose was 1 g ivgtt qd, the difference of cardiac function between patients with heart disease and coronary heart disease was significantly different from that of conventional treatment group. (OR=4.87, 95%CI1.7~13.98, P>0.001); at the dose of 1 g ivgtt bid, the sodium creatine phosphate group was more effective than the conventional treatment group in improving cardiac function in patients with coronary heart disease (OR= 9.73, 95%CI4.05~23.40,P<0.001); when the dose was 2 g ivgtt qd, the sodium creatine phosphate group was more effective than the conventional treatment group in improving cardiac function in patients with coronary heart disease (OR=6.11, 95%CI2.93~12.72, P<0.001); the improvement of 1 g bid dose was better than 2 g qd and 1 g qd. Conclusion Sodium creatine phosphate can alleviate the clinical symptoms of patients with coronary heart disease and improve cardiac function, and has certain clinical efficacy. At the same time, the effect of sodium creatine phosphate on improving cardiac function in patients with coronary heart disease and heart failure has a certain correlation with the dose and frequency of administration.

参考文献/References:

[1]杨菲菲,智光,王秋霜.肺部超声在心力衰竭应用中的研究进展[J].中华老年心脑血管病杂志,2017,19(3):325-327. [2]黄峻.中国心力衰竭流行病学特点和防治策略[J].中华心脏与心律电子杂志,2015,3(2):2-3. [3]Gustafsson F,Rogers JG.Left ventricular assist device therapy in advanced heart failure:patient selection and outcomes[J].Eur J Heart Fail,2017,19(5):595-602. [4]Pocock SJ,Wang D,Pfeffer MA,et al.Predictors of mortality and morbidity in patients with chronic heart failure[J].Eur Heart J,2006,27(1):65-75. [5]倪晶宇,李澜,李敏,等.慢性心力衰竭与能量代谢重构关系的研究进展[J].中国临床药理学杂志,2017,33(5):474-477. [6]黄晓渝,鲁桓,孟丽琴,等.磷酸肌酸钠治疗急性心肌梗死心力衰竭的临床观察[J].现代医药卫生,2010,26(15):2261-2262. [7]李作成.注射用磷酸肌酸钠治疗急性心肌梗死后心力衰竭的疗效[J].中国老年学杂志,2010,30(16):2371-2372. [8]邓恩平,黄汉光,李艳.磷酸肌酸钠治疗冠心病合并心力衰竭疗效观察[J].海南医学,2011,22(3):88-89. [9]张灼辉,谭健强,苏小红.注射用磷酸肌酸钠治疗冠心病慢性充血性心力衰竭[J].中西医结合心脑血管病杂志,2011,9(7):772-773. [10]黎军德,左梅.磷酸肌酸钠治疗老年冠心病心力衰竭疗效观察[J].吉林医学,2011,32(29):6119-6120. [11]滕伟,薛永亮,何兆辉,等.磷酸肌酸钠对冠心病并慢性心力衰竭患者B型利钠肽及心功能的影响[J].中国医药导报,2012,9(18):59-60. [12]陈红梅,徐开联,付延导.磷酸肌酸钠在治疗冠心病合并心力衰竭的应用研究[J].当代医学,2012,18(17):133-134. [13]王爱琴.磷酸肌酸钠治疗51例冠心病合并心力衰竭的疗效观察[J].中国医学创新,2013,10(3):130-131. [14]杨瑗.磷酸肌酸钠治疗老年冠心病心力衰竭疗效观察[J].医药论坛杂志,2013,34(9):104-105. [15]刘园园.注射用磷酸肌酸钠治疗51例冠心病合并慢性充血性心力衰竭的疗效观察[J].中国伤残医学,2013,21(4):156-157. [16]张玉红.观察注射用磷酸肌酸钠治疗急性心肌梗死后心力衰竭的疗效[J].中外医疗,2013,32(16):108,110. [17]张道全,高建忠,布和.注射用磷酸肌酸钠治疗冠心病并慢性心力衰竭的疗效观察[J].中国实用医药,2014(10):142-143. [18]王万里.磷酸肌酸钠治疗冠心病合并心力衰竭的疗效能对心功能的改善作用[J].中西医结合心血管病杂志(电子版),2015,3(16):17-18. [19]周徐洲,苏倬杰,陈伟亮.急性心肌梗死后心力衰竭患者使用磷酸肌酸钠的效果[J].牡丹江医学院学报,2016,37(4):61-62. [20]张良芬,赵韵超.磷酸肌酸钠治疗高龄冠心病合并心力衰竭的体会[J].世界最新医学信息文摘(电子版),2016(32):13-14. [21]王珊珊,张红,陈穗,等.磷酸肌酸钠治疗老年冠状动脉粥样硬化性心脏病舒张性心力衰竭的临床效果[J].中国医药,2016,11(2):154-157. [22]Gaddi AV,Galuppo P,Yang J.Creatine Phosphate Administration in Cell Energy Impairment Conditions: A Summary of Past and Present Research[J].Heart Lung Circ,2017(17):1-10. [23]田帅,张利宣,马子健,等.慢性心力衰竭患者应用磷酸肌酸钠治疗对心功能和NT-probnp的影响[J].河北医药,2016,38(14):2173-2175. [24]刘状.磷酸肌酸钠治疗慢性心力衰竭疗效及对患者血清相关细胞因子水平的影响[J].医学临床研究,2018,35(11):2164-2166. [25]张彬,赵宏.磷酸肌酸的心肌保护机制及其在心脏疾病中的应用[J].医学综述,2008,14(2):262-264. [26]王波,欧阳艳红,方小丽,等.苦碟子联合磷酸肌酸钠对冠心病合并心力衰竭患者血清脂联素水平及心功能的影响[J].中国老年学杂志,2015,36(19):5510-5512. [27]汪砚雨,栾琴.磷酸肌酸钠对慢性心力衰竭患者CgA、BNP等指标水平的影响[J].实验与检验医学,2017,35(4):952,954-602. [28]陈佳怡.注射用磷酸肌酸钠在冠状动脉搭桥术围手术期的心肌保护作用[J].中外医学研究,2017,15(13):31-32. [29]赵文静,侯荣华,刘婷,等.磷酸肌酸钠治疗原发性肝癌介入术后所致心肌损伤的疗效分析[J].现代肿瘤医学,2016,24(16):2568-2570. [30]尹成芳.丹红注射液联合磷酸肌酸钠治疗慢性心力衰竭病人的疗效及不良反应分析[J].内蒙古医科大学学报,2019,41(4):429-431. [31]勾振山.磷酸肌酸钠对急诊PCI 术中缺血再灌注心肌的保护作用研究[J].黑龙江医药,2019,32(4):807-808. [32]Ying W,Chen Y.Efficiency of Creatine Phosphate Sodium and Hyzaar in hypertensive patients withdiastolic dysfunction[J].Heart,2013,99(suppl3):A222. [33]Wang FR,Zheng X.Effects of phosphocreatine on plasma brain natriuretic peptide level and left ventricular function in patients with heart failure[J].PJCCPVD,2008(16):29-31. [34]周德明,陈明,张小明.磷酸肌酸钠对高龄严重肺部感染并发心力衰竭患者心肌酶及B型尿钠肽的影响[J].贵州医药,2019,43(7):1071-1072. [35]刘宁,刘吴,白华,等.芪苈强心胶囊联合磷酸肌酸对冠心病合并心力衰竭病人血清脂联素与心功能的影响[J].中西医结合心脑血管病杂志,2016,14(7):673-675. [36]周沃联,黄琪述,周丽华,等.磷酸肌酸钠对老年心力衰竭患者血清超敏C反应蛋白、同型半胱氨酸、BNP的影响[J].中国现代药物应用,2016,10(11):194-195.

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更新日期/Last Update: 2019-10-15