期刊文献+

心房颤动中的室率控制和节律控制策略 被引量:9

Efficacy of rate and rhythm control strategy in patients with atrial fibrillation: meta-analysis
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摘要 目的 室率控制和节律控制是临床治疗心房颤动(房颤)的两种基本策略.为了进一步比较两种治疗策略在不同人群中的获益,该研究入选了10个前瞻性随机临床研究进行荟萃分析.方法 以房颤、室率控制、节律控制、随机对照试验为检索词,对MEDLINE、The Cochrane Library、The Clinical Trials 和中国维普期刊数据库进行系统检索,检索截止时间为2010年5月31日.结果 该研究总入选人群7876例,3932例分布在室率控制组,3944例分布在节律控制组.结果显示,在总体年龄中,室率控制组的住院率明显低于节律控制组(17.56%与22.98%,OR:0.37,95% CI:0.19~0.71);而在平均年龄<65岁的亚组人群中,室率控制组的总病死率(3.6%与1.9%,OR:1.89,95%CI:1.01~3.53)和进行性加重的心力衰竭事件(2.3%与0.3%,OR:5.6,95% CI:1.44~21.69)明显高于节律控制组.而对于血栓栓塞事件和出血事件,在总体人群和亚组人群中,两组之间差异无统计学意义.结论研究结果提示,对于相对年轻的房颤患者,节律控制策略可能优于室率控制策略. Objective The efficacy of rate and rhythm control strategies for treating atrial fibrillation(AF)patients was analyzed in this meta-analysis.Methods Eligible trials were searched in MEDLINE,the Cochrane Library,the Clinical Trials,the Chinese VIP database up to May 31,2010.Ten prospective randomized control trials with 7876 patients(rate control n =3932,rhythm control n =3944)were included for final analysis.Results All cause mortality(5.3% vs.5.0% ; OR: 1.03 ; 95% CI:0.84-1.26; I2 〈25%)and incidence of worsening heart failure(3.81% vs.3.61% ; OR: 1.04; 95% CI:0.80-1.36; I2 〈 50%)were similar between the two groups.Subgroup analysis showed that all cause mortality(3.6% vs.1.9% ; OR: 1.89; 95% CI: 1.01-3.53; I2 〈25%)and rate of worsening heart failure (2.3% vs.0.3% ; OR: 5.6 ; 95% CI: 1.44-21.69 ; I2 〈 25%)were significantly higher in rate control group than in rhythm control group in patients with age 〈 65 years.Thromboembolic events(1.49% vs.1.46% ; OR: 1.02,95% CI: 0.71-1.48)and bleeding events(1.78% vs.1.73% ; OR: 1.02,95%CI:0.70-1.49)were similar between rhythm control and rate control groups while rehospitalization rate was significantly lower in rate control group than in rhythm control group(17.56% vs.22.98% ; OR: 0.37,95% CI: 0.19-0.71).Conclusion This meta-analysis shows that rhythm control strategy is superior to rate control strategy for AF patients with age 〈 65 years in terms of reducing all cause mortality and incidence of worsening heart failure.
出处 《中华心血管病杂志》 CAS CSCD 北大核心 2012年第1期68-72,共5页 Chinese Journal of Cardiology
关键词 心房颤动 心率 心律失常 Atrial fibrillation Heart rate Arrhythmia
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参考文献23

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同被引文献102

  • 1尹巧香,王恒,罗慧兰.老年心力衰竭合并心房颤动的临床特点及预后[J].实用老年医学,2013,27(3):233-236. 被引量:3
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