目的 系統(tǒng)評價納美芬治療慢性阻塞性肺疾?。–OPD）并發(fā)Ⅱ型呼吸衰竭的臨床療效和安全性。方法 檢索中文學(xué)術(shù)期刊全文數(shù)據(jù)庫（CNKI）、維普中文期刊全文數(shù)據(jù)庫（VIP）、中國生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫（CBM）、萬方數(shù)據(jù)庫（Wanfang Data）、PubMed、Web of Science、The Cochrane Library、Embase和Wiley Online Library，檢索時間均為建庫至2021年4月30日，收集納美芬（試驗組）對比納洛酮或空白對照（對照組）治療COPD并發(fā)Ⅱ型呼吸衰竭的隨機(jī)對照試驗（RCTs）。由2名評價者對符合納入的研究進(jìn)行獨立的質(zhì)量評價、數(shù)據(jù)提取后采用RevMan 5.3軟件對結(jié)局指標(biāo)數(shù)據(jù)進(jìn)行 Meta分析。結(jié)果 共納入13篇RCTs，1 122例患者。Meta分析結(jié)果顯示，試驗組的臨床有效率［RR=1.22，95% CI（1.15，1.29），P<0.01］、pH增加值［SMD=1.01，95% CI （0.67，1.34），P<0.01］、氧分壓（pO₂）增加值［SMD=1.87，95% CI（1.73，2.02），P<0.01］、二氧化碳分壓（pCO₂）下降值［SMD=-0.91，95% CI（-1.03，-0.78），P<0.01］、第1秒用力呼氣量（FEV1）增加值［SMD=1.06，95% CI（0.87，1.25），P<0.01］均優(yōu)于對照組，且未增加藥物不良反應(yīng)發(fā)生率 ［RR=1.50，95% CI（0.55，4.08），P>0.05］。結(jié)論 納美芬能顯著改善COPD并發(fā)Ⅱ型呼吸衰竭患者呼吸衰竭癥狀，改善肺功能。

Objective To systematically evaluate the efficacy and safety of nalmefene in the treatment of chronic obstructive pulmonary disease (COPD) complicated with type Ⅱ respiratory failure. Methods Data was retrieved from CNKI, VIP, Wanfang Data, CBM, PubMed, Web of Science, The Cochrane Library, Embase, Wiley Online Library until the 30 th January 2021. Screening a randomized controlled trial (RCT) of nalmefene (experimental group) vs naloxone or blank control (control group) in the treatment of COPD complicated with type Ⅱ respiratory failure. Two reviewers conducted independent quality evaluations for the included studies. After data extraction, RevMan 5.3 software was used for Meta-analysis. Results A total of 13 RCTs and 1 122 patients were included. Meta-analysis results showed that the nalmefene group in the clinical effective rate [RR= 1.22, 95%CI (1.15, 1.29), P<0.01], pH arise [SMD= 1.01, 95%CI (0.67, 1.34), P<0.01], pO₂ arise [SMD= 1.87, 95%CI (1.73, 2.02), P<0.01], pCO₂ decline [SMD= -0.91, 95%CI (-1.03, -0.78), P<0.01], FEV1 arise [SMD= 1.06, 95%CI (0.87, 1.25), P<0.01] were better than those of the control group, and the incidence of adverse drug reactions was not increased [RR= 1.50, 95%CI (0.55, 4.08), P>0.05]. Conclusion Nalmefene can significantly improve the respiratory symptoms of COPD patients with type Ⅱ respiratory failure, improve lung function.

R974;R969.3

河北省衡水市科技計劃（2016014092Z）