背景:失代偿性心力衰竭住院是一个主要的公共卫生问题。
方法:我们进行了一项荟萃分析,以总结和分析在降低死亡率或再入院方面,使用超滤是否优于利尿剂。首先确定了10项随机对照试验(RCTs),包括941例患者。
结果:与利尿剂相比,超滤治疗与心力衰竭住院率显着降低(风险比[RR]:0.72;95%置信区间[CI]:0.55-0.96,p=0.02)以及体重和净液体损失显着增加(平均差异[MD]:-1.55,CI:-2.36至-0.74,p=0.0002)和(MD:-2.10,CI:-3.32至-0.89,p=0.0007)分别。关于住院时间,治疗之间没有显着差异,血清肌酐水平升高,和死亡率。
结论:在失代偿性心力衰竭患者中,与利尿剂相比,超滤与减少再住院和增加体重/净液体损失有关。
BACKGROUND: Hospitalization for decompensated heart failure is a major public health issue.
METHODS: We performed a meta-analysis to summarize and analyze if there is a benefit in using
ultrafiltration over diuretics in terms of reducing mortality or hospital readmissions, primarily and identified 10 randomized controlled trials (RCTs) including 941 patients.
RESULTS: Compared to diuretics, treatment with
ultrafiltration was associated with a significant reduction in heart failure hospitalizations (risk ratio [RR]: 0.72; 95% confidence interval [CI]: 0.55-0.96, p = 0.02) and significant increase in weight and net fluid loss (mean difference [MD]: -1.55, CI: -2.36 to -0.74, p = 0.0002) and (MD: -2.10, CI: -3.32 to -0.89, p = 0.0007), respectively. There was no significant difference among treatments regarding the duration of hospitalization, the increase in serum creatinine levels, and mortality.
CONCLUSIONS: Among patients with decompensated heart failure, compared to diuretics,
ultrafiltration is associated with reduced rehospitalizations and increased weight/net fluid loss.