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 對高血壓病合并多種慢性疾病的老年患者進行老年綜合評估(comprehensive geriatric assessment,CGA)。方法 采用老年綜合評估量化表,對2006年3月—2009年9月確診的高血壓及非高血壓患者進行全面的評估,通過t檢驗、秩和檢驗及方差分析分別探討其整體功能狀態及生活質量差異。結果 單純高血壓病老年患者在日常生活能力、認知、營養狀態、睡眠、步態及平衡功能等方面與非高血壓對照組人群比較有統計學意義(Plt;005);高血壓合并一項及兩項其他慢性疾病(2型糖尿病、冠心病)患者在日常生活能力、睡眠、抑郁方面與非高血壓對照組比較亦有統計學意義。結論 高血壓病患者機體功能和生活質量顯著降低,合并其他慢性疾病可以使生活質量進一步下降。