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目的:系统评价普罗帕酮与胺碘酮转复心房颤动(房颤)的疗效以及安全性。方法:通过计算机检索中英文电子文献数据库,收集有关普罗帕酮以及胺碘酮治疗房颤的随机对照试验(RCTs),由两位评估者独立进行筛选以及评价,对合格的文献应用RevMan5.2软件进行Meta分析。结果:共纳入符合标准的RCTs文献12篇,Meta分析结果提示:1用药后观察时间充分的条件下(观察时间≥24h)转复房颤的有效性普罗帕酮组差于胺碘酮组(OR=0.55,95%CI:0.38~0.80,P=0.02)。2用药后转复房颤的平均转复时间普罗帕酮组明显短于胺碘酮组(WMD=-3.48h,95%CI:-5.23h~-1.73h,P<0.000 1),口服普罗帕酮组转复房颤时间明显短于口服胺碘酮组(WMD=-5.28h,95%CI:-6.84h~-3.71h,P<0.000 01),静脉普罗帕酮组转复房颤时间明显短于静脉胺碘酮组(WMD=-2.58h,95%CI:-4.35h~-0.81h,P<0.000 01)。312组RCTs显示普罗帕酮组与胺碘酮组在总不良反应、心血管系统内不良反应、心血管系统以外的不良反应及严重不良事件上均无明显统计学差异。结论:在观察时间(≥24h)充分的条件下,胺碘酮具备更高的转复率,但普罗帕酮具备更快的转复时间。两组不良反应发生率不具有统计学差异,安全性无显著差异。
Objective: To systematically evaluate the efficacy and safety of propafenone and amiodarone in the treatment of atrial fibrillation (AF). METHODS: Randomized controlled trials (RCTs) of propafenone and amiodarone in patients with atrial fibrillation were collected by computer-assisted search of Chinese and English electronic literature databases, independently screened and evaluated by two reviewers, and RevMan 5.2 was applied to eligible literature Meta-analysis software. Results: A total of 12 eligible RCTs were enrolled in this study. The results of Meta analysis indicated that the effectiveness of atrial fibrillation after propofol treatment was less than that of amiodarone group OR = 0.55, 95% CI: 0.38-0.80, P = 0.02). 2 The average recovery time of AF after atrial fibrillation was significantly shorter in the propafenone group than in the amiodarone group (WMD = -3.48h, 95% CI: -5.23h ~ -1.73h, P <0.0001) The duration of atrial fibrillation was significantly shorter in the propanone group than in the oral amiodarone group (WMD = -5.28h, 95% CI: -6.84h to -3.71h, P <0.000 01) The time was significantly shorter than the intravenous amiodarone group (WMD = -2.58h, 95% CI: -4.35h -0.81h, P <0.000 01). 312 groups of RCTs showed no difference between the propafenone group and the amiodarone group in adverse reactions, adverse reactions in the cardiovascular system, adverse reactions outside the cardiovascular system and serious adverse events. Conclusions: Amiodarone has a higher rate of reversion at adequate time (> 24 h), but propafenone has a faster time to recovery. There was no significant difference in the incidence of adverse reactions between the two groups, with no significant difference in safety.