Objective To assess the effectiveness and safety of meglumine adenosine cyclophosphate (MAC) for chronic heart failure. Methods The databases such as Cochrane Central Register of Controlled Trials (Issue 3, 2011), MEDLINE (1950 to March 2011), EMbase (1980 to March 2011), CNKI (1995 to March 2011), and VIP (1989 to March 2011) were searched, and the relevant journals and conference proceedings were also manually retrieved. Then the studies were screened according to predefined inclusion and exclusion criteria, and their quality was evaluated. Meta-analyses were performed by using RevMan 5.0 software. Results Seventeen randomized controlled trials (RCTs) involving 1 281 patients were included. All of the included RCTs were Grade C in methodological quality. The results of meta-analyses showed that MAC plus routine treatment was superior to routine treatment in improving the left ventricular ejection fraction (WMD=5.75, 95%CI 3.61 to 7.89), stroke volume (SV) (WMD=5.55, 95%CI 3.71 to 7.38), E/A (WMD=0.09, 95%CI 0.05 to 0.14) and 6 min walk test (WMD=43.52, 95%CI 21.00 to 66.04). But MAC plus routine treatment was similar to routine treatment in regulating cardiac index (CO) (WMD=0.20, 95%CI –0.31 to 0.71) and heart rate (WMD=0.64, 95%CI –7.49 to 8.77). No significant adverse effects or allergic reactions were reported. Conclusion The current evidence shows that MAC may improve the left ventricular ejection fraction, stroke volume, E/A and 6 min walk test. Due to a high risk of selection bias and detection bias in the included studies, the evidence is insufficient to determine the effectiveness of MCA. Further large-scale trials are required to define the role of MAC in the treatment of chronic heart failure.
〖GK3!3〗〖HT5”H〗【摘要】 目的 对高血压病合并多种慢性疾病的老年患者进行老年综合评估(comprehensive geriatric assessment,CGA)。方法 采用老年综合评估量化表,对2006年3月—2009年9月确诊的高血压及非高血压患者进行全面的评估,通过t检验、秩和检验及方差分析分别探讨其整体功能状态及生活质量差异。结果 单纯高血压病老年患者在日常生活能力、认知、营养状态、睡眠、步态及平衡功能等方面与非高血压对照组人群比较有统计学意义(Plt;005);高血压合并一项及两项其他慢性疾病(2型糖尿病、冠心病)患者在日常生活能力、睡眠、抑郁方面与非高血压对照组比较亦有统计学意义。结论 高血压病患者机体功能和生活质量显著降低,合并其他慢性疾病可以使生活质量进一步下降。