Chinese Medical Sciences Journal ›› 2020, Vol. 35 ›› Issue (3): 226-238.doi: 10.24920/003678

• 论著 • 上一篇    下一篇

曲美他嗪对糖尿病合并冠心病患者的疗效:一项随机对照试验的荟萃分析

林烨1,王祯莲1,严敏1,朱飞雨1,端烨1,孙志琴2,*()   

  1. 1常州大学制药学院,常州,213164
    2常州市第二人民医院,常州,213164
  • 收稿日期:2020-01-13 出版日期:2020-09-30 发布日期:2020-09-25
  • 通讯作者: 孙志琴 E-mail:sun_zhiqin@163.com

Effect of Trimetazidine on Diabetic Patients with Coronary Heart Diseases: A Meta-Analysis of Randomized, Controlled Trials

Lin Ye1,Wang Zhenlian1,Yan Min1,Zhu Feiyu1,Duan Ye1,Sun Zhiqin2,*()   

  1. 1School of Pharmacy, Changzhou University, Changzhou 213164, China
    2Changzhou No. 2 People's Hospital, Changzhou 213164, China
  • Received:2020-01-13 Published:2020-09-30 Online:2020-09-25
  • Contact: Sun Zhiqin E-mail:sun_zhiqin@163.com

摘要:

目的 探讨曲美他嗪对糖尿病合并冠心病患者的治疗作用。
方法 我们检索PubMed,EMBASE和Cochrane数据库中2019年5月之前收录的所有关于曲美他嗪对糖尿病合并冠心病患者疗效的随机对照研究。采用Cochrane Collaboration推荐的偏倚风险评估方法评估文献质量。采用用随机或固定模型获得左心室功能、血清葡萄糖代谢、血清脂代谢、心肌缺血发作和运动耐量的合并平均差异,效应大小由95%置信区间(CI)表示。
结果 曲美他嗪辅助治疗有助于改善患者的左心室射血分数(WMD=4.39,95%CI:3.83,4.95,P<0.00001),左心室舒张末期直径(WMD=-3.17,95%CI:-4.90,-1.44,P=0.0003)和左心室收缩末期直径(WMD=-4.69,95%CI:-8.66,-0.72,P=0.02)。曲美他嗪还能降低空腹血糖(SMD=-0.43,95%CI:-0.70,-0.17,P=0.001)、糖基化血红蛋白水平(WMD=-0.59,95%CI:-0.95,-0.24,P=0.001),血清总胆固醇水平(WMD=-20.36,95%CI:-39.80,-0.92,P=0.04)、低密度脂蛋白胆固醇水平(WMD=-20.12,95%CI:-32.95,-7.30,P=0.002),心肌缺血发作的发生率(SMD=-0.84,95%CI:-1.50,-0.18,P=0.01)。然而,曲美他嗪不能显著降低血清甘油三酯及高密度脂蛋白胆固醇水平,改善运动耐量。
结论 曲美他嗪辅助治疗能有效改善糖尿病合并冠心病患者的心功能、血糖、血脂代谢及临床症状。

关键词: 曲美他嗪, 冠心病, 糖尿病, 心室功能, 血清糖代谢

Abstract:

Objective To explore the therapeutic effects of trimetazidine (TMZ) on diabetic patients with coronary heart diseases.
Methods We conducted a comprehensive electronic search of PubMed, EMBASE, and Cochrane databases between the inception dates of databases and May 2019 (last search conducted on 30 May 2019) to identify randomized controlled trials. The evaluation method recommended by Cochrane Collaboration for bias risk assessment was employed for quality assessment. Random or fixed models were used to investigate pooled mean differences in left ventricular function, serum glucose metabolism, serum lipid profile, myocardial ischemia episodes and exercise tolerance with effect size indicated by the 95% confidence interval (CI).
Results Additional TMZ treatment contributed to considerable improvement of left ventricular ejection fraction (WMD=4.39, 95%CI: 3.83, 4.95, P<0.00001), left ventricular end diastolic diameter (WMD=-3.17, 95%CI: -4.90, -1.44, P=0.0003) and left ventricular end systolic diameter (WMD=-4.69, 95%CI: -8.66, -0.72, P=0.02). TMZ administration also significantly decreased fasting blood glucose (SMD=-0.43, 95%CI: -0.70, -0.17, P=0.001), glycosylated hemoglobin level (WMD=-0.59, 95%CI: -0.95, -0.24, P=0.001), serum level of total cholesterol (WMD=-20.36, 95%CI: -39.80, -0.92, P=0.04), low-density lipoprotein cholesterol (WMD=-20.12, 95%CI: -32.95, -7.30, P=0.002) and incidence of myocardial ischemia episodes (SMD=-0.84, 95%CI: -1.50, -0.18, P=0.01). However, there were no significant differences in serum triglyceride level, high-density lipoprotein cholesterol, exercise tolerance between the TMZ group and the control group.
Conclusion TMZ treatment in diabetic patients with coronary heart disease is effective to improve cardiac function, serum glucose and lipid metabolism and clinical symptoms.

Key words: trimetazidine, coronary heart diseases, diabetes mellitus, ventricular function, serum glucose metabolism

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