Department of Emergency Medicine, People's Hospital of Daxing District, Beijing, China.
Comput Math Methods Med. 2022 Aug 18;2022:8916791. doi: 10.1155/2022/8916791. eCollection 2022.
Systematic evaluation of the efficacy of natriuretic recombination in human brain on disease myocardial infarction, left ventricular heart failure, and the efficacy and safety of long-term left ventricular remodeling.
Computerized search of CNKI, Wanfang database, Wipro Chinese Technology Publications (VIP) numerical database, Chinese Biomedical Literature Database (CBM), Medline Cochrane Library, clinical Trail.Gov clinical collection, and other documents. Randomized controlled trials (RCT) of recombinant human brain natriuretic peptide in the treatment of acute myocardial infarction from inception to December 2021 were searched. Based on the Jadad scale, inclusion-exclusion data for diseases were collected and elaborated by meta by RevMan 5.3 simulation software. In a total of 23 randomized controlled trials, 2 024 cases were used as the basic data, the control group was routinely treated for 1 012 cases, and 1 012 cases in the experimental group were also treated with natriuretic peptide in the recombinant human brain on the previous basis.
In terms of overall efficacy, the experimental group was better than the control group, statistically significant (OR = 4.30, 95% CI (3.26, 5.67), < 0.000 01), left ventricular ejection fraction in the experimental group than the control group (OR = 1.58, 95% CI (1.27, 1.90), < 0.000 01). In terms of a myocardial strain in the left ventricle, the experimental group was superior to the control group. The difference was significant (OR = -0.91, 95% CI (-1.50, -0.33), = 0.002). In terms of the cardiac output volume, the experimental group was superior to the control group (OR = 1.24, 95% CI (0.55, 1.94), = 0.0005). Regarding brain natriuretic peptide precursors, the experimental group was superior to the control group (OR = -4.37, 95% CI (-6.21, -3.25), < 0.00001). In terms of the heart rate, the experimental group was superior to the control group. Measurement of differential significance is as follows: OR = -13.70, 95% CI (-14.95, -12.46), < 0.00001. In terms of contraction, the experimental group was superior to the comparison group (OR = -12.38, 95% CI (-17.98, -6.79), < 0.00001). The experimental group outperformed the control group (OR = -7.42, 95% CI (-8.53, -6.30), < 0.00001). In terms of bad influence, the measurement is as follows: OR = 0.95, 95% CI (0.29, 3.16), = 0.94.
In patients with acute myocardial infarction and left ventricular remodeling, if treated with a heavy treatment of the group of cerebral natriuretic peptide mode, it can increase clinical treatment, improve the cardiac effect, inhibit ventricular remodeling, improve blood pressure and heart rhythm, and have greater clinical treatment and safety.
系统评价脑利钠肽重组体在治疗心肌梗死、左心室心力衰竭、左心室重构长期疗效和安全性中的作用。
计算机检索中国知网、万方数据库、维普中文科技期刊数据库、中国生物医学文献数据库、Medline Cochrane Library、ClinicalTrials.gov 临床试验注册库等，收集重组人脑利钠肽治疗急性心肌梗死的随机对照试验，检索时限均为建库至 2021 年 12 月。根据 Jadad 量表对纳入文献进行质量评价及数据提取，采用 RevMan 5.3 软件进行 meta 分析。共纳入 23 项随机对照试验，2024 例患者作为基本数据，对照组常规治疗 1012 例，实验组在对照组基础上加用脑利钠肽重组体治疗 1012 例。
在整体疗效方面，实验组优于对照组，差异有统计学意义（OR=4.30，95%CI（3.26，5.67）， < 0.000 01），实验组左心室射血分数优于对照组（OR=1.58，95%CI（1.27，1.90）， < 0.000 01）。在左心室心肌应变方面，实验组优于对照组，差异有统计学意义（OR=-0.91，95%CI（-1.50，-0.33）， = 0.002）。在心输出量方面，实验组优于对照组（OR=1.24，95%CI（0.55，1.94）， = 0.0005）。在脑钠肽前体方面，实验组优于对照组（OR=-4.37，95%CI（-6.21，-3.25）， < 0.00001）。在心率方面，实验组优于对照组，差异有统计学意义，测量如下：OR=-13.70，95%CI（-14.95，-12.46）， < 0.00001。在收缩功能方面，实验组优于对照组（OR=-12.38，95%CI（-17.98，-6.79）， < 0.00001）。实验组优于对照组（OR=-7.42，95%CI（-8.53，-6.30）， < 0.00001）。在不良影响方面，测量结果为：OR=0.95，95%CI（0.29，3.16）， = 0.94。
在急性心肌梗死并左心室重构患者中，如果采用脑利钠肽重组体的强化治疗模式，可以提高临床治疗效果，改善心功能，抑制心室重构，改善血压和心律，具有更大的临床治疗及安全性。
