ACEI联合丹参酮治疗肺心病急性加重期的疗效和安全性的meta分析

doi:10.5246/jcps.2022.11.072

摘要/Abstract

摘要：

肺心病急性加重(AECPHD)危及生命, 常规治疗加ACEI并不理想。研究表明, 血管紧张素转换酶抑制剂(ACEI)和丹参酮联合应用可控制AECPHD, 但有效性和安全性始终未被系统性评价。本文旨在运用meta分析对其有效性、安全性进行系统性的评价。结果表明, ACEI联合丹参酮的有效性高于ACEI单用AECPD, 表现为总体有效率增加, 平均肺动脉压下降、二氧化碳分压下降、氧分压升高。联合治疗组不良事件发生率高于对照组, 但结果不稳定。需要进一步的大规模、多中心随机对照试验(RCT)来研究联合治疗的安全性。

关键词: 依那普利, 卡托普利, 丹参酮, meta分析, 肺心病急性加重

Abstract:

Acute exacerbation of pulmonary heart disease (AECPHD) is life-threatening. Conventional therapy plus angiotensin-converting enzyme inhibitors (ACEI) is not always practical. Recent trials have suggested the beneficial effects of the combination of ACEI and tanshinone on AECPHD. In the present study, we aimed to evaluate its efficacy and safety by meta-analysis systematically. The result indicated that combination of ACEI and tanshinone was more effective than ACEI monotherapy in AECPHD, as represented by treatment efficiency and mean pulmonary arterial pressure, PaCO2, and PaO2. However, the incidence of adverse events of combined therapy was higher than the control group, while the result of the analysis for adverse events was unstable. Further large-scale, multicenter, and rigorously designed randomized controlled trials (RCT) are needed to evaluate the efficacy and safety of combined therapy.

Key words: Enalapril, Captopril, Tanshinone, Meta-analysis, AECPHD

Supporting:

Supplementary Figure 1. Funnel plot of treatment efficiency.

Supplementary Figure 2. Egger’s test of treatment efficiency.

Supplementary Figure 3. Forrest plot of treatment efficiency after trimming and filling.

Supplementary Figure 4. Funnel plot of treatment efficiency after trimming and filling.

Supplementary Figure 5. Sensitivity analysis of of treatment efficiency.

Supplementary Figure 6. Funnel plot of mPVP.

Supplementary Figure 7. Egger’s test of mPVP.

Supplementary Figure 8. Forrest plot of mPVP after trimming and filling.

Supplementary Figure 9. Funnel plot of mPVP after trimming and filling.

Supplementary Figure 10. Sensitivity analysis of of mPVP.

Supplementary Figure 11. Funnel plot of PaCO_2.

Supplementary Figure 12. Forrest plot of PaCO₂ after trimming and filling.

Supplementary Figure 13. Funnel plot of PaCO₂ after trimming and filling.

Supplementary Figure 14. Sensitivity analysis of of PaCO_2.

Supplementary Figure 15. Funnel plot of PaO₂.

Supplementary Figure 16. Forrest plot of PaO₂ after trimming and filling.

Supplementary Figure 17. Funnel plot of PaO₂ after trimming and filling.

Supplementary Figure 18. Sensitivity analysis of of PaO_2.

Supplementary Figure 19. Funnel plot of Adverse events .

Supplementary Figure 20. Forrest plot of adverse events after trimming and filling.

Supplementary Figure 21. Funnel plot of adverse events after trimming and filling.

Supplementary Figure 22. Sensitivity analysis of of adverse events.

李敏, 常路路, 岳向峰, 杜书章. ACEI联合丹参酮治疗肺心病急性加重期的疗效和安全性的meta分析[J]. 中国药学(英文版), 2022, 31(11): 853-865.

Min Li, Lulu Chang, Xiangfeng Yue, Shuzhang Du. Efficacy and safety of ACEI plus tanshinone for acute exacerbation of pulmonary heart disease: a meta-analysis[J]. Journal of Chinese Pharmaceutical Sciences, 2022, 31(11): 853-865.

图/表 10

Figure 1. Flowchart of the process for literature retrieval.

Table 1. Characteristics of the included studies.

Figure 2. Risk of bias.

Figure 3. Risk of bias summary and graph.

Figure 4. Forrest plot of treatment efficiency.

Figure 5. Subgroup analysis of treatment efficiency.

Figure 6. Forrest plot of mPAP.

Figure 7. Forrest plot of PaCO2.

Figure 8. Forrest plot of PaO2.

Figure 9. Forrest plot of adverse events.

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