【摘要】 目的:系统评价沙库巴曲缬沙坦治疗射血分数保留心力衰竭(HFpEF)的有效性与安全性。方法:运用万方、中国知网、中国生物医学文献服务系统、PubMed、EMBASE、WebofScience等数据库检索自启动期至2022年1月15日期间沙库巴曲缬沙坦用于HFpEF患者的随机对照试验。结果:共有13项研究8754名参与者符合纳入标准。本研究结果显示，与对照组相比，沙库巴曲缬沙坦可降低HFpEF患者的心衰再住院率[OR=0.76,95%CI(0.67,0.85),P=0.000],改善NYHA心功能分级[OR=1.85,95%CI(1.32,2.59),P=0.001],降低治疗后N末端脑钠肽前体(NT-proBNP)水平[SMD=-3.20,95%CI(-4.25,-2.14),P=0.001],增加患者6min步行试验(6MWT)的步行距离[WMD=57.51,95%CI(21.51,93.52),P=0.002];但在心血管死亡率、不良反应发生率、生活质量评分及左心房大小方面无显著差异(P均>0.05)。结论:沙库巴曲缬沙坦可以显著改善HFpEF患者的NT-proBNP、6MWD、NYHA心功能分级、心衰再住院率，而在心血管死亡率、不良反应发生率、生活质量评分及左心房大小方面无显著优势。更多还原

【Abstract】 Objective:To systematically evaluate the effectiveness and safety of sacubitril-valsartan in the treatment of heart failure with preserved ejection fraction(HFpEF). Methods: Randomized controlled trials of sacubitril-valsartan in HFpEF patients from initiation to Jan 15, 2022 were searched in Wanfang, CNKI, China Biomedical Literature Service, PubMed, Embase, and Web of Science databases. Results:A total of 8754 participants from 13 studies met the inclusion criteria. Results of the present study indicated that compared with control group, sacubitril-valsartan could reduce heart failure-caused rehospitalization rate [OR=0.76, 95%CI(0.67, 0.85), P=0.001], improve NYHA cardiac function class [OR=1.85, 95%CI(1.32, 2.59), P=0.001], reduce level of NT-proBNP after treatment [SMD=-3.20, 95%CI(-4.25,-2.14), P=0.001]and improve the walking distance of 6 MWT[WMD=57.51, 95%CI(21.51, 93.52), P=0.002]. However, there were no significant difference in cardiovascular mortality, incidence rate of adverse reactions, quality of life score, and left atrium size, P>0.05 all. Conclusion:Sacubitril-valsartan can significantly improve NT-proBNP, 6 MWD, NYHA class and heart failure-caused rehospitalization rate in HFpEF patients, while there are no significant advantages in cardiovascular mortality, incidence rate of adverse reactions, quality of life score, and left atrium size.更多还原