目的 運(yùn)用Meta分析方法評(píng)價(jià)法舒地爾治療肺動(dòng)脈高壓的療效。方法 計(jì)算機(jī)檢索中國(guó)期刊全文數(shù)據(jù)庫(CNKI)、中文科技期刊全文數(shù)據(jù)庫(VIP)、萬方數(shù)字化期刊全文庫、Pubmed和Cochrane library, 對(duì)納入的隨機(jī)對(duì)照試驗(yàn)文獻(xiàn)進(jìn)行質(zhì)量評(píng)價(jià), 并采用Rev Man 5.3軟件進(jìn)行Meta分析。結(jié)局指標(biāo)為總有效率、6分鐘步行試驗(yàn)(6MWT)、肺動(dòng)脈收縮壓(sPAP)、血氧飽和度(SaO₂)。結(jié)果 共納入13篇隨機(jī)對(duì)照試驗(yàn), 共933例患者。Meta分析結(jié)果顯示, 法舒地爾加用常規(guī)治療可有效提高肺動(dòng)脈高壓患者的臨床療效［RR＝1.27, 95%CI(1.15, 1.40), P<0.01］和6MWT［WMD＝51.82, 95%CI(40.66, 62.97), P<0.01］, 降低sPAP［WMD＝-6.91, 95%CI(-8.11, -5.71), P<0.01］。SaO₂亞組分析, 法舒地爾加用常規(guī)治療可有效提高肺動(dòng)脈高壓患者的SaO₂(P<0.01), 慢性肺源性心臟病組:WMD＝7.85, 95%CI(5.68, 10.01)、多種原發(fā)病組:WMD＝3.18, 95%CI(1.35, 5.01)。結(jié)論 法舒地爾治療肺動(dòng)脈高壓具有較好的療效, 但仍需開展高質(zhì)量的藥物臨床試驗(yàn)。

Objective To evaluate the efficacy of fasudil in treatment of pulmonary arterial hypertension (PAH) by Meta analysis. Methods By searching China Journal Full-text Database (CNKI), Technology Journal Full-text Database (VIP), Wanfang Database, Pubmed, and Cochrane library, etc, the quality assessment of qualified randomly control trials was evaluated. Meta analysis was carried out by Rev Man 5.3 software. The outcomes included the clinical effects, the 6 min walk distance (6MWT), systolic pulmonary artery pressure (sPAP), and the oxygen saturation of blood (SaO₂). Results A total of 13 studies were included, involving 933 patients. Meta analysis showed that fasudil could significantly increase in clinical effects [RR = 1.27, 95%CI (1.15, 1.40), P < 0.01], and 6MWT [WMD = 51.82, 95% CI(40.66, 62.97), P < 0.001], and decrease in sPAP [WMD = -6.91, 95%CI (-8.11, -5.71), P < 0.01]. Subgroup analysis showed fasudil could markedly elevate SaO₂ in patients of chronic cor pulmonale group [WMD = 7.85, 95%CI (5.68, 10.01)], and multiple protopathy group [WMD = 3.18, 95%CI (1.35, 5.01)]. Conclusion Fasudil could improve the clinical efficacy of pulmonary arterial hypertension, but it is necessary to carry out high quality of drug clinical trials.