目的 系統(tǒng)評價呋塞米聯用小劑量多巴胺治療中國利尿劑抵抗性心力衰竭的有效性和安全性。方法 檢索PubMed、Embase、中國生物醫(yī)學文獻數據庫（CBM）、中國學術期刊全文數據庫（CNKI）、維普中文期刊全文數據庫（VIP）和萬方數據庫，收集呋塞米聯用小劑量多巴胺（觀察組）對比單用呋塞米（對照組）對利尿劑抵抗性心力衰竭的隨機對照研究（RCT），檢索時間從建庫至2019年7月，提取資料并評價質量后，采用RevMan 5.3軟件進行Meta-分析。結果 共納入12篇RCTs，927例中國患者。Meta-分析結果顯示觀察組臨床有效率（RR=1.44，95% CI=1.32~1.56）、左心室射血分數增加值（MD=8.05，95% CI=7.52~8.75）、24 h尿量體積（SMD=2.77，95% CI=1.93~3.62）、6 min步行距離（MD=38.97，95% CI=24.10~53.85）均大于對照組，差異有統(tǒng)計學意義（P<0.01）；血清肌酐水平（MD=-2.86，95% CI=-6.46~0.73）和藥物不良反應發(fā)生率（MD=1.64，95% CI=0.59~4.57）與對照組比較無顯著差異。結論 對于心力衰竭合并利尿劑抵抗的中國患者而言，小劑量多巴胺聯用呋塞米改善患者心功能、尿潴留、活動耐受力和抑制腎功能不全等均優(yōu)于單用呋塞米，且安全性較好。

Objective To evaluate the efficacy and safety of furosemide combined with low dose dopamine in the treatment of diuretic resistant heart failure in China. Methods The randomized controlled trials (RCT) of furosemide combined with low dose dopamine (test group) vs furosemide alone (control group) of in the treatment of diuretic resistant heart failure in Chinese were searched from the database including Pubmed, Embase, CNKI, VIP, CBM and Wangfang by computer from the database to July 2019. References of included studies were also retrieved. Screened studies according to inclusion and exclusion criteria, extracted valid data, and assessed the methodological quality of including literatures. Meta-analysis was performed using RevMan 5.3 software. Results A total of 12 RCTs and 927 patients were included. Meta-analysis showed that the clinical effective rate (RR=1.44, 95%CI=1.32~1.56), left ventricular ejection fraction increased (MD=8.05, 95%CI=7.52~8.75), 24 h urine volume (SMD=2.77, 95%CI=1.93~3.62], 6 min WDT (MD=38.97, 95%CI=24.10~53.85) in the test group were significantly higher than those in the control group (P<0.01); and there was no significant difference in serum creatinine level[MD=-2.86, 95%CI=-6.46~0.73] and adverse drug reactions[MD=1.64, 95%CI=0.59~4.57] between the two groups. Conclusion For Chinese patients with diuretic resistant heart failure, furosemide combined with low dose dopamine can improves cardiac function, urinary retention, activity tolerance and renal dysfunction, and safety is good.

R972;R983