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首页> 外文期刊>Scientific reports. >Levosimendan in patients with left ventricular dysfunction undergoing cardiac surgery: a meta-analysis and trial sequential analysis of randomized trials
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Levosimendan in patients with left ventricular dysfunction undergoing cardiac surgery: a meta-analysis and trial sequential analysis of randomized trials

机译：左右丹丹患者患有心脏手术的左心室功能障碍：随机试验的荟萃分析和试验顺序分析

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Patients with left ventricular dysfunction (LVD) undergoing cardiac surgery have a high mortality rate. Levosimendan, a calcium sensitizer, improves myocardial contractility without increasing myocardial oxygen demand. It is not clear whether levosimendan can reduce mortality in cardiac surgery patients with LVD. The PubMed, Embase, and Cochrane Central databases were searched to identify randomized trials comparing levosimendan with conventional treatment in cardiac surgery patients with LVD. We derived pooled risk ratios (RRs) with random effects models. The primary endpoint was perioperative mortality. Secondary endpoints were renal replacement treatment, atrial fibrillation, myocardial infarction, ventricular arrhythmia, and hypotension. Fifteen studies enrolling 2606 patients were included. Levosimendan reduced the incidence of perioperative mortality (RR: 0.64, 95%CI: 0.45–0.91) and renal replacement treatment (RR:0.71, 95%CI:0.52–0.95). However, sensitivity analysis, subgroup analysis and Trial Sequential Analysis (TSA) indicated that more evidence was needed. Furthermore, levosimendan did not reduce the incidence of atrial fibrillation (RR:0.82, 95%CI:0.64–1.07), myocardial infarction (RR:0.56, 95%CI:0.26–1.23), or ventricular arrhythmia (RR:0.74, 95%CI:0.49–1.11), but it increased the incidence of hypotension (RR:1.11,95%CI:1.00–1.23). There was not enough high-quality evidence to either support or contraindicate the use of levosimendan in cardiac surgery patients with LVD.
机译：患有左心室功能障碍（LVD）的患者进行心脏手术的死亡率高。 Levosimendan是一种钙敏化剂，改善了心肌收缩力，而不会增加心肌需氧。目前尚不清楚Levosimendan是否可以减少心脏手术患者LVD的死亡率。搜查了PubMed，Embase和Cochrane中央数据库，以确定与LVD心脏手术患者的常规治疗比较Levosimendan的随机试验。我们使用随机效果模型来源的汇集风险比（RRS）。主要终点是围手术期的死亡率。次要终点是肾脏替代治疗，心房颤动，心肌梗死，心律失常和低血压。包括15项注册2606名患者的研究。 Levosimendan降低了围手术期死亡率的发生率（RR：0.64,95％CI：0.45-0.91）和肾置换处理（RR：0.71,95％CI：0.52-0.95）。然而，敏感性分析，亚组分析和试验顺序分析（TSA）表示需要更多的证据。此外，Levosimendan没有降低心房颤动的发生率（RR：0.82,95％CI：0.64-1.07），心肌梗死（RR：0.56,95％CI：0.26-1.23）或心间心律失常（RR：0.74,95 ％CI：0.49-1.11），但它增加了低血压的发生率（RR：1.11,95％CI：1.00-1.23）。没有足够的高质量证据来支持或禁忌在心脏手术患者的LVD中使用Levosimendan。

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