贝那普利对中国慢性心力衰竭患者心功能的影响：随机对照试验的荟萃分析

[Effect of benazepril on cardiac function in Chinese patients with chronic heart failure: a meta-analysis of randomized controlled trials].

作者信息

Yan Xiaowei, Xu Dingli, Huang Jun

机构信息

Email:

Department of Cardiology, First Affiliated Hospital, Nanjing Medical University, Nanjing 210029, China. Email:

出版信息

Zhonghua Yi Xue Za Zhi. 2014 Oct 14;94(37):2907-13.

PMID:25549643

Abstract

OBJECTIVE

To evaluate the efficacy and tolerability of benazepril in Chinese patients with chronic systolic heart failure.

METHODS

We searched the databases of Cochrane, PubMed, EMbase, CBM and CNKI from January 1989 to November 2010 for the relevant studies. Two investigators identified randomized controlled trials (RCTs) independently according to the predefined inclusion and exclusion criteria. Statistical data analysis was performed with the Stata 11 software.

RESULTS

A total of 15 studies with 1 355 Chinese patients of chronic systolic heart failure fulfilled the inclusion criteria. Among them, 546 received benazepril monotherapy. The dose range of benazepril was 5 to 40 mg daily. And it was similar to angiotensin II receptor blockers (ARBs) in improving left ventricular ejection fraction (LVEF)(P = 0.674), reducing LVEDD (P = 0.511) and improving cardiac output (P = 0.363). The combination therapy of benazepril and ARB was superior to ARB monotherapy in reducing left ventricular end-diastolic diameter (LVEDD) (P = 0.001). However, LVEF was comparable between patients with ACEI/ARB combination therapy and those with ARB monotherapy (P = 0.105). Compared with blank control, benazepril treatment was associated with a significant improvement in LVEF from baseline to follow-up (WMD = 6.5%; 95% CI: 0.9%, 12.0%; P = 0.022). Compared with baseline, benazepril treatment significantly increased LVEF (WMD = 10.4%; 95% confidence interval [CI]:7.1%, 13.8%; P < 0.001) and cardiac output (WMD = 1.5 L; CI:0.3, 2.6 L, P = 0.016). A significant reduction in LVEDD (WMD = 5.3 mm; CI: 2.7, 7.8 mm, P < 0.001) was also observed in benazepril group. As the most common side effect after benazepril treatment, cough had a prevalence of 11.6%. Other side effects were rare.

CONCLUSION

Benazepril is both efficacious and safe in the management of Chinese patients with chronic heart failure.

摘要

目的

评估贝那普利对中国慢性收缩性心力衰竭患者的疗效和耐受性。

方法

检索1989年1月至2010年11月Cochrane、PubMed、EMbase、中国生物医学文献数据库（CBM）和中国知网（CNKI）中的相关研究。两名研究者根据预先设定的纳入和排除标准独立识别随机对照试验（RCT）。使用Stata 11软件进行统计数据分析。

结果

共有15项研究纳入1355例中国慢性收缩性心力衰竭患者，符合纳入标准。其中，546例接受贝那普利单药治疗。贝那普利的剂量范围为每日5至40毫克。在改善左心室射血分数（LVEF）（P = 0.674）、降低左心室舒张末期内径（LVEDD）（P = 0.511）和增加心输出量（P = 0.363）方面，其与血管紧张素II受体阻滞剂（ARB）相似。贝那普利与ARB联合治疗在降低左心室舒张末期内径（LVEDD）方面优于ARB单药治疗（P = 0.001）。然而，ACEI/ARB联合治疗组与ARB单药治疗组患者的LVEF相当（P = 0.105）。与空白对照相比，贝那普利治疗使LVEF从基线至随访有显著改善（加权均数差[WMD]=6.5%；95%可信区间[CI]：0.9%，12.0%；P = 0.022）。与基线相比，贝那普利治疗显著增加LVEF（WMD = 10.4%；95%可信区间[CI]：7.1%，13.8%；P < 0.001）和心输出量（WMD = 1.5升；CI：0.3，2.6升，P = 0.016）。贝那普利组还观察到LVEDD显著降低（WMD = 5.3毫米；CI：2.7，7.8毫米，P < 0.001）。作为贝那普利治疗后最常见的副作用，咳嗽发生率为11.6%。其他副作用少见。