摘要
目的血管紧张素转化酶抑制剂（ACEI）联合血管紧张素受体拮抗剂（ARB）对心力衰竭患者安全性分析。方法计算机检索Embase、PubMed、CoChrane图书馆、维普、中国知网数据库。按照纳入与排除标准选择文献、提取资料和评价纳入研究的方法学质量后，采用Revman5．3软件进行Meta分析。结果对11篇随机对照试验（RCT）的18160例患者进行了Meta分析。对照组为ACEI常规治疗，试验组为ACEI＋ARB联合治疗。接受联合治疗不良反应显著增加，其中低血压风险增加1.1％（WMD=1．91，95％CI：1．37～2．66，P〈0．01，I2=22％），高血钾0．6％（WMD=4．17，95％CI：2．31～7．53，P=0．02，I2=56％）；加重肾功能损害差异无统计学意义（WMD=2．73，95％CI：0．76～9．77，P=0．12，I2=84％），咳嗽无显著性差异（WMD=0．84，95％CI：0．65～1．09，P=0．18，I2=0％）。结论ARB类药物与ACEI类药物联用治疗心力衰竭应注意观察不良反应。
Objective To compare the combination therapy of ACEI and ARB vs. ACEI alone of heart failure risk of adverse reaction occurred. Methods Using computer to retrieve EMBASE,PUBMED,The Cochrane Register of Controlled Trials and VIP, CNKI and Wan Fang about ACEI and ARB comparative alone ACEI treatment of heart failure randomized controlled trials,according to include and exclude criteria selection literature,extract information and evaluation into the study of methodological quality, using the Cochrane Revmanb. 3 software for Meta analysis. Results A total of 11 randomized controlled trials （RCTs）were adopted, the number of cases total of 18 I60 cases,application Revmanb. 3 software for statistical analysis. ACEI routine therapy in control, the combination of ACEI and ARB in experimental,Adverse reactions of combination of ACEI and ARB increased significantly, of which 1.1% increased risk of low blood pressure （WMD=1. 91,95%CI=1.37-2.66,P〈0. 000 01,I2=22%） ,0.6% hyperkalemia （WMD =4.17,95%CI=2.31- 7.53,P=0.02,I2 =56%）. Deterioration of renal function there was no significant difference （WMD = 2.73,95 % CI = 0. 76 - 9. 77, P = 0. 12, I2= 84 % ）, cough there was no significant difference （WMD） 0. 84,95% CI 0.65-1.09,P= 0.18, I2 = 0）. Conclusion Heart failure in patients with ACEI and ARB combined lead to adverse reactions than ACEI alone increased. Show that ARE drugs is not often added to the ACEI treatment for heart failure. If you choose combination should observe adverse reactions.
出处
《重庆医学》
CAS
北大核心
2016年第22期3091-3095,共5页
Chongqing medicine
基金
新疆维吾尔自治区自然基金(2014211C102)
作者简介
郑丽丽（1980-），主管药师，硕士，主要从事临床药学及循证药学研究。通讯作者，E-mail：1519531677@qq．com。
