1,6—二磷酸果糖治疗心力衰竭有效性的系统评价

目的:评价1,6—二磷酸果糖(FDP)治疗心力衰竭(HF)的有效性。方法:检索Medlinf、Embase、Cochrane临床试验数据库、CBM和CNKI等文献数据库,收集FDP治疗HF的临床研究并进行质量评价,对符合纳入标准的临床研究进行Meta分析。结果:共纳入14篇随机对照研究,全部为中文。纳入研究的Jadad质量评分均为1分。所有研究均未进行随访,无法对FDP用于HF治疗的远期效果进行评价。14项研究的合并分析显示FDP可增加HF治疗的有效率,比值比(OR,95%可信区间)为3.79(2.58,5.57)。5项研究的合并分析显示FDP可增加心脏指数,权重均数差值(WMD,95%可信区间)为0.40(0.34,0.46)。6项研究合并分析显示FDP可增加心脏的射血分数,WMD(95%可信区间)为8.31(5.51,11.11)。4项研究的合并分析显示FDP可降低HF患者左室舒张末期容积和左室收缩末期容积,WMD分别为—3.25(—4.74,—1.76)和—3.75(—6.94,—0.56)。此外有2项研究提示FDP对心输出量也有改善作用。结论:目前的临床研究证据表明,FDP可提高HF治疗的有效率,对于反映心功能和左室结构的指标具有改善作用。但目前的研究质量欠佳,且缺乏对长期效果评价的证据,有必要进行大规模、设计良好的随机对照研究以证实FDP治疗HF的有效性。

1,6-Diphosphate Fructose in Heart Failure: A Systematic Review

OBJECTIVE:To assess the effectiveness of 1,6—diphosphate fructose(FDP)in the treatment of heart failure(HF).METHODS:Biomedical databases,including Medline,Embase,Cochrane Controlled Trials Register,CBM and CNKI were searched.Clinical trials were screened according to the inclusion criteria formulated beforehand,quality assessments and meta anylysis of included studies were carried out.RESULTS:14 randomized controlled trial were included,and all of them were carried out in China.Jadad score of the studies were all 1.None of the 14 trials carried out by follow-up domization for long-term effect evulation Meta-analysis of 14 trials showed that FDP can increase effective rate in the treatment of HF,and OR(95%CI)was 3.79(2.58,5.57).5 studies showed that FDP can increase cardic index,and WMD(95%CI)was 0.40(0.34,0.46).6 studies showed that FDP can increase ejection fraction(EF)with WMD(95%CI)8.31(5.51,11.11).4 studies showed that FDP can decrease left ventricular end systolic and diastolic diameter,and WMD was—3.25(—4.74,—1.76)and—3.75(—6.94,—0.56).No long-term effects were reported by the included studies.CONCLUSIONS:According to present evidence,FDP can increase the treatment effective rate when added to the basic treatment of HF.FDP can improve heart function and lefe ventricular construction showed by the indicators.However,the poor quality of the studies decreased the persuasion of the results.Large-scale and well-designed RCTs with enough follow-ups should be carried out to provide further evidence for the use of FDP.