背景:慢性心力衰竭(CHF)一直对人类的生存和健康构成重大威胁。补充硫胺素对CHF患者的疗效尚不确定。
目的:接受补充硫胺素可能不会给CHF患者带来益处。
方法:在Cochrane图书馆进行了全面搜索,PubMed,EMBASE,ClinicalTrials.gov,和WebofScience数据库直到2023年5月,以确定研究补充硫胺素对CHF患者的影响的文章。使用预定义的标准来选择有关研究特征和结果的数据。
结果:七个随机分组,双盲,纳入总共274例患者的对照试验(5项平行试验和2项交叉试验).汇总这些研究的荟萃分析结果未显示与安慰剂相比,硫胺素治疗对左心室射血分数有任何显着影响(WMD=1.653%,95%CI:-1.098至4.405,p=0.239,I2=61.8%),左心室舒张末期容积(WMD=-6.831mL,95%CI:-26.367至12.704,p=0.493,I2=0.0%),6分钟步行试验(WMD=16.526m,95%CI:-36.582至69.634,p=0.542,I2=66.3%),N末端B型利钠肽前体(WMD=258.150pg/mL,95%CI:-236.406至752.707,p=0.306,I2=21.6%),或纽约心脏协会类别(WMD=-0.223,95%CI:-0.781至0.335,p=0.434,I2=87.1%)。然而,它有效地改善了硫胺素缺乏症(TD)的状况。
结论:我们的荟萃分析表明,补充硫胺素对CHF没有直接治疗作用,除了修正TD。
BACKGROUND: Chronic heart failure (CHF) has always posed a significant threat to human survival and health. The efficacy of thiamine supplementation in CHF patients remains uncertain.
OBJECTIVE: Receiving supplementary thiamine may not confer benefits to patients with CHF.
METHODS: A comprehensive search was conducted across the Cochrane Library, PubMed, EMBASE, ClinicalTrials.gov, and Web of Science databases up until May 2023 to identify articles investigating the effects of thiamine supplementation in CHF patients. Predefined criteria were utilized for selecting data on study characteristics and results.
RESULTS: Seven randomized, double-blind, controlled trials (five parallel trials and two crossover trials) involving a total of 274 patients were enrolled. The results of the meta-analysis pooling these studies did not reveal any significant effect of thiamine treatment compared with placebo on left ventricular ejection fraction (WMD = 1.653%, 95% CI: -1.098 to 4.405, p = 0.239, I2 = 61.8%), left ventricular end-diastolic volume (WMD = -6.831 mL, 95% CI: -26.367 to 12.704, p = 0.493, I2 = 0.0%), 6-min walking test (WMD = 16.526 m, 95% CI: -36.582 to 69.634, p = 0.542, I2 = 66.3%), N-terminal pro-B type natriuretic peptide (WMD = 258.150 pg/mL, 95% CI: -236.406 to 752.707, p = 0.306, I2 = 21.6%), or New York Heart Association class (WMD = -0.223, 95% CI: -0.781 to 0.335, p = 0.434, I2 = 87.1%). However, it effectively improved the status of thiamine deficiency (TD).
CONCLUSIONS: Our meta-analysis indicates that thiamine supplementation does not have a direct therapeutic effect on CHF, except for correcting TD.