2011.9.7-万爽力心功能不全幻灯幻灯片.pptVIP

Data on LVEF from all 11 articles are shown in Figure 1. Heterogeneity was observed when analyzing all studies and a random-effect model was used. Overall, TMZ improved LVEF when all studies were taken into the analysis, with a mean improvement of 6.88% (95% confidence interval [CI]: 5.50–8.25). * The WMSI was significantly reduced with TMZ compared with placebo (P = 0.004) in the meta-analysis of 6 articles (Figure 2). Heterogeneity was observed and the reduction in WMSI was 0.23 (95% CI: 0.07–0.38) * Data from 6 articles were used in the meta-analysis of LVESV (Figure 3). Heterogeneity was observed, and LVESV was significantly reduced in the TMZ group (P 0.001), with a mean reduction of 11.58 mL (95% CI: 5.79–17.37). However, in the meta-analysis of 6 articles, the effect of TMZ on LVEDV was not superior to placebo (Figure 4). Heterogeneity was observed, and the mean change in LVEDV was ?2.24 mL (95% CI: –12.36–7.88). Sensitivity analysis showed that effect was not statistically significant (P ≥0.39). When 1 study16 was withdrawn from the meta-analysis, because it was negative with 98.63% weight (Figure 5), the result changed to ?2.91 (95% CI: –3.68–9.50). Funnel plots showed no asymmetry of the data. * * 结论及临床意义 与安慰剂相比，万爽力显著提高LVEF和LVESV，改善左室功能、提高运动耐量 该研究证实了万爽力改善心绞痛患者左心功能的有效性，代谢治疗是心绞痛合并心力衰竭治疗的新选择 总 结 心力衰竭严重影响人类健康 联合万爽力?全面优化心衰治疗 减轻症状，提高生活质量 改善左室功能，降低死亡率 研究证实可以获益的心功能不全人群 缺血性心脏病合并心功能不全 非缺血性心脏病合并心功能不全 谢 谢！ * * 缺血性心脏病或心肌缺血是一个连续的、动态发展的过程。一般来说，往往早期冠脉粥样硬化至心肌缺血仅表现为动态心电图ST段压低，并没有心绞痛等表现。粥样硬化持续进展，斑块逐渐增大，当劳累等诱因出现时，心肌氧供需不平衡，即可出现典型的心绞痛表现，如不恰当治疗，发展为急性冠脉综合征的风险将大大增加，急性冠脉事件幸存患者往往发展为心功能不全，后者是由任何结构性或功能性的心脏异常引起的、影响心室灌注或泵血能力的临床综合征，也是我们此次科室会讨论的重点。 * 随着冠心病治疗手段的日新月异，冠心病死亡率逐渐降低。图为《美国心血管疾病/脑卒中统计年鉴2010》，左边为冠心病患者死亡率，即从上世纪80年代至2006年，冠心病年死亡人数已降至450/千人以下，女性略高于男性；但出院患者心力衰竭发病率却逐年增加，而且增势非常稳定。由此可见心力衰竭已成为目前心血管治疗中亟待解决的问题。 * 重组B型钠尿肽（奈西利肽）作为治疗药物静脉给药处置已经证明可以最佳化ADHF治疗的风险/收益率。 * 摘要 Abstract Objective—To describe the survival of a population based cohort of patients with incident (new) heart failure and th