法舒地尔治疗肺动脉高压疗效的Meta分析

目的运用Meta分析方法评价法舒地尔治疗肺动脉高压的疗效。方法计算机检索中国期刊全文数据库(CNKI)、中文科技期刊全文数据库(VIP)、万方数字化期刊全文库、Pubmed和Cochrane library,对纳入的随机对照试验文献进行质量评价,并采用Rev Man 5.3软件进行Meta分析。结局指标为总有效率、6分钟步行试验(6MWT)、肺动脉收缩压(s PAP)、血氧饱和度(Sa O2)。结果共纳入13篇随机对照试验,共933例患者。Meta分析结果显示,法舒地尔加用常规治疗可有效提高肺动脉高压患者的临床疗效RR=1.27,95%CI(1.15,1.40),P0.01]和6MWTWMD=51.82,95%CI(40.66,62.97),P0.01],降低s PAPWMD=-6.91,95%CI(-8.11,-5.71),P0.01]。Sa O2亚组分析,法舒地尔加用常规治疗可有效提高肺动脉高压患者的Sa O2(P0.01),慢性肺源性心脏病组:WMD=7.85,95%CI(5.68,10.01)、多种原发病组:WMD=3.18,95%CI(1.35,5.01)。结论法舒地尔治疗肺动脉高压具有较好的疗效,但仍需开展高质量的药物临床试验。

Meta analysis on effect of fasudil in treatment of pulmonary arterial hypertension

Objective To evaluate the efficacy of fasudil in treatment of pulmonary arterial hypertension (PAH) by Meta analysis. Methods By searching China Journal Full-text Database (CNKI), Technology Journal Full-text Database (VIP), Wanfang Database, Pubmed, and Cochrane library, etc, the quality assessment of qualified randomly control trials was evaluated. Meta analysis was carried out by Rev Man 5.3 software. The outcomes included the clinical effects, the 6 min walk distance (6MWT), systolic pulmonary artery pressure (sPAP), and the oxygen saturation of blood (SaO₂). Results A total of 13 studies were included, involving 933 patients. Meta analysis showed that fasudil could significantly increase in clinical effects RR = 1.27, 95%CI (1.15, 1.40), P < 0.01], and 6MWT WMD = 51.82, 95% CI(40.66, 62.97), P < 0.001], and decrease in sPAP WMD = -6.91, 95%CI (-8.11, -5.71), P < 0.01]. Subgroup analysis showed fasudil could markedly elevate SaO₂ in patients of chronic cor pulmonale group WMD = 7.85, 95%CI (5.68, 10.01)], and multiple protopathy group WMD = 3.18, 95%CI (1.35, 5.01)]. Conclusion Fasudil could improve the clinical efficacy of pulmonary arterial hypertension, but it is necessary to carry out high quality of drug clinical trials.