摘要
目的:探讨艾司洛尔治疗心脏术后新发心房颤动的疗效和安全性。方法:计算机检索PubMed、MEDLINE、Embase、the Cochrane Library、中国生物医学文献数据库、中国知网、万方数据库和维普数据库,检索时间均为建库至2023年12月31日。搜集艾司洛尔治疗心脏术后新发心房颤动的随机对照试验(RCT,艾司洛尔组患者采用艾司洛尔治疗,对照组患者采用地尔硫[艹卓]或毛花苷治疗),根据纳入与排除标准,利用EndNote软件进行文献筛查,提取资料、评价纳入研究的偏倚风险后,使用Stata 17.0软件进行Meta分析。结果:共纳入11项RCT,包括666例患者。Meta分析结果显示,与对照组比较,艾司洛尔组患者的心室率显著降低,差异有统计学意义(MD=-11.85,95%CI=-18.80~-4.90,P=0.001);两组患者有效率(RR=1.08,95%CI=0.99~1.17,P=0.095)、不良反应发生率(RR=0.84,95%CI=0.63~1.12,P=0.219)的差异均无统计学意义。结论:当前证据表明,艾司洛尔治疗心脏术后新发心房颤动仅在控制心室率方面有效,与其他术后心房颤动常用药物(如地尔硫[艹卓]或毛花苷)相比,其在有效率和不良反应发生率方面并无明显优势。鉴于目前研究数量和质量的限制,上述结论仍需更多高质量研究加以验证。
OBJECTIVE:To explore the efficacy and safety of esmolol in the treatment of new atrial fibrillation after cardiac surgery.METHODS:PubMed,MEDLINE,Embase,the Cochrane Library,CBM,CNKI,Wanfang Data and VIP were retrieved from the establishment of the database to Dec.31st,2023.Randomized controlled trials(RCT)of estolol in the treatment of new atrial fibrillation after cardiac surgery were collected(patients in esmolol group were treated with esmolol,and while the control group received diltiepine or lanatoside).According to the inclusion and exclusion criteria,literature screening was performed by using EndNote software,and after extracting information and evaluating the risk of bias of the included studies,Meta-analysis was performed by using Stata 17.0 software.RESULTS:A total of 11 RCT were enrolled,including 666 patients.Meta-analysis showed that compared with the control group,the ventricular rate in esmolol group was significantly lower,with statistically significant difference(MD=-11.85,95%CI=-18.80--4.90,P=0.001).There were no significant differences in the effective rate(RR=1.08,95%CI=0.99-1.17,P=0.095)and incidence of adverse drug reactions(RR=0.84,95%CI=0.63-1.12,P=0.219)between two groups.CONCLUSIONS:Current evidence suggests that esmolol is only effective in the control of ventricular rate in the treatment of new atrial fibrillation after cardiac surgery.Compared with other commonly used drugs for postoperative atrial fibrillation(such as diltiazepines or lanthanin),esmolol has no significant advantages in terms of effective rate and incidence of adverse reactions.Due to the limited number and quality of current studies,more high-quality studies are needed to confirm these conclusions.
作者
李海志
杨瑞
徐文秀
李特
LI Haizhi;YANG Rui;XU Wenxiu;LI Te(Dept.of Pharmacy,Fuwai Yunnan Hospital,Chinese Academy of Medical Sciences/Affiliated Cardiovascular Hospital of Kunming Medical University,Kunming 650102,China;Medical College,Yunnan College of Business Management,Kunming 650106,China)
出处
《中国医院用药评价与分析》
2025年第1期89-92,97,共5页
Evaluation and Analysis of Drug-use in Hospitals of China
基金
云南省教育厅科学研究基金项目(No.2025J0314)
云南省科技厅昆医联合专项-面上项目(No.202401AY070001-286)
云南高原心血管病流行特征、发病机制、诊疗新技术研究及应用示范项目(No.202103AC100004)。
关键词
艾司洛尔
术后心房颤动
心脏术后新发心房颤动
META分析
系统评价
随机对照试验
Esmolol
Postoperative atrial fibrillation
New atrial fibrillation after cardiac surgery
Meta-analysis
Systematic review
Randomized controlled trials
