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[1]费宇行,李晶,邢娜,等.托伐普坦治疗充血性心力衰竭的疗效和安全性评价——meta分析[J].国际心血管病杂志,2017,04:245-249.
　FEI Yuxing,LI Jing,XING Na,et al.Efficacy and safety of tolvaptan in paitients with congestive heart failure——meta analysis[J].International Journal of Cardiovascular Disease,2017,04:245-249.
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托伐普坦治疗充血性心力衰竭的疗效和安全性评价——meta分析(PDF)

《国际心血管病杂志》[ISSN:1006-6977/CN:61-1281/TN]

期数:
2017年04期
页码:
245-249
栏目:
临床研究
出版日期:
2017-07-25

文章信息/Info

Title:
Efficacy and safety of tolvaptan in paitients with congestive heart failure——meta analysis
作者:
费宇行; 李晶; 邢娜; 黄毅雄; 张蓉; 徐世侠
100048 北京,海军总医院心内科(费宇行,黄毅雄,张 蓉 ),干部心血管科(李 晶),信息科(邢 娜; 徐世侠)
Author(s):
FEI Yuxing1;  LI Jing2;  XING Na3;  HUANG Yixiong1;  ZHANG Rong1;  XU Shixia3
1. Department of Cardiology; 2. Department of Cadre Cardiology; 3. Department of Information, Navy General Hospital of PLA, Beijing 100048, China
关键词:
充血性心力衰竭; 托伐普坦; 随机对照研究; meta分析
Keywords:
Congestive heart failure;  Tolvaptan;  Randomized control trial;  Meta analysis
分类号:
-
DOI:
10.3969/j.issn.1673-6583.2017.04.013
文献标识码:
-
摘要:
目的:评价托伐普坦对充血性心力衰竭的治疗效果及安全性。方法:通过检索Pubmed、中国生物医学文献等数据库,手工检索已纳入的相关文献,对符合随机对照条件的研究经质量评估、数据提取,进行meta分析。结果:纳入10项随机、双盲、安慰剂对照研究。共计5086例病例,4958例完成研究设计随访。Meta分析结果显示,治疗组体质量(单位:0.1kg)减轻[加权均数差(WMD)=-8.29,95%CI:-9.38～-7.20,P<0.001],尿量(单位:100mL)增加(WMD=14.58,95%CI:8.22～20.95,P<0.001),血钠(单位:mmol/L)增加(WMD=2.83,95%CI:1.66～4.01,P<0.01);与安慰剂比较,长期治疗的主要不良反应为口渴、口干和尿频;亚组分析显示,短期(1周)治疗,不良事件发生率无明显增加(WMD=1.35,95%CI:0.61～2.97,P=0.46)。托伐普坦对死亡率和再住院率无明显影响。结论:充血性心力衰竭患者选择性使用托伐普坦(30mg/d)可以减轻体液潴留、纠正低钠血症,长期用药可能出现口渴、口干和尿频。
Abstract:
Objective:To assess the efficacy and safety of tolvaptan in patients with congestive heart failure.Methods:We performed a systemic search and identification in the Pubmed, CBM databases and et al to collect randomized controlled trials(RCT)study. The reference literature were retrieved manually. After quality assessment and data extraction, all the studies were given meta-analysis.Results:We enrolled 10 RCT studies with a total of 5 086 patients, of whom 4 958 were followed over. The results showed that the body weight(unit: 0.1 kg)decreased(WMD=-8.29, 95%CI=-9.38～-7.20, P<0.001)while the urine volume(unit: 100 mL)(WMD=14.58, 95%CI:8.22～20.95, P<0.001 )and serum sodium(unit: mmol/L)(WMD=2.83, 95%CI:1.66～4.01, P<0.01)increased significantly in tolvaptan group compared with control group. The main adverse events of long-term treatment were thirst, dry mouth and frequent micturition compared with placebo. In subgroup, the adverse events were similar to the control during short-term(1 week)treatment(WMD=1.35, 95%CI=0.61～2.79, P=0.46). There was no difference in death and rehospitalization between two groups.Conclusions:Selective use of tolvaptan(30 mg/d)in patients with congestive heart failure can reduce fluid retention and correct hyponatremia. Long-term use may result in thirst, dry mouth and frequent micturition.

参考文献/References

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备注/Memo

备注/Memo:
通信作者:徐世侠,Email:xushixia65@hotmail.com
更新日期/Last Update: 2017-07-25