左西孟旦对晚期心力衰竭患者的抗炎和血液动力学作用：已发表研究的荟萃分析。
The anti-inflammatory and haemodynamic effects of levosimendan on advanced heart failure patients: a meta-analysis of published studies.
机构信息
Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, China.
Department of Medical Image, the Third Hospital of Nanchang, Nanchang, Jiangxi Province, China.
出版信息
J Int Med Res. 2023 Jul;51(7):3000605221148402. doi: 10.1177/03000605221148402.
OBJECTIVE
Increasing evidence from randomized controlled trials shows the anti-inflammatory and haemodynamic effects of levosimendan in advanced heart failure (AdHF), however, conflicting results have been reported in some studies. The aim of this study was to estimate the anti-inflammatory and haemodynamic effects of levosimendan on AdHF (registration number: INPLASY202250097).
METHODS
The MEDLINE, PubMed, ClinicalTrials.com and Cochrane Library databases were systematically searched for studies published in English up to April 2019. Data were extracted from applicable articles. Meta-analyses were performed to assess interleukin (IL)-6, cardiac index, pulmonary artery pressure (PAP) and New York Heart Association (NYHA) functional class efficacy outcomes, following PRISMA 2020 guidelines.
RESULTS
A total of 11 studies were included (211 patients who received levosimendan and 193 controls). Meta-analyses showed that the levosimendan group displayed significantly reduced IL-6 (standardized mean difference [SMD] -1.05; 95% confidence interval [CI] -1.44, -0.66; I= 50.9%), improved cardiac index (SMD 0.59; 95% CI 0.29, 0.88; I= 0.0%); reduced PAP (SMD -1.22; 95% CI -1.91, -0.53; I= 89.7%) and improved NYHA functional class (SMD -1.66; 95% CI -2.27, -1.04; I= 74.6%) versus controls.
CONCLUSIONS
Levosimendan infusion was beneficial in patients with AdHF, displayed by anti-inflammatory and improved haemodynamic effects, and improved NYHA functional class.
目的
越来越多的随机对照试验证据表明，左西孟旦在晚期心力衰竭（AdHF）中具有抗炎和血液动力学作用，然而，一些研究报告了相互矛盾的结果。本研究旨在评估左西孟旦对 AdHF 的抗炎和血液动力学作用（注册号：INPLASY202250097）。
方法
系统检索了截至 2019 年 4 月发表的英文文献的 MEDLINE、PubMed、ClinicalTrials.com 和 Cochrane Library 数据库。从适用文章中提取数据。根据 PRISMA 2020 指南进行荟萃分析，以评估白细胞介素（IL）-6、心指数、肺动脉压（PAP）和纽约心脏协会（NYHA）功能分类疗效结局。
结果
共纳入 11 项研究（211 例接受左西孟旦治疗的患者和 193 例对照）。荟萃分析显示，左西孟旦组的 IL-6 明显降低（标准化均数差[SMD]-1.05；95%置信区间[CI]-1.44，-0.66；I=50.9%），心指数改善（SMD 0.59；95%CI 0.29，0.88；I=0.0%），PAP 降低（SMD-1.22；95%CI-1.91，-0.53；I=89.7%），NYHA 功能分类改善（SMD-1.66；95%CI-2.27，-1.04；I=74.6%）。
结论
与对照组相比，左西孟旦输注对 AdHF 患者有益，表现为抗炎和改善血液动力学作用，并改善 NYHA 功能分类。
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