Objective To evaluate the effectiveness and safety of AAI pacing mode versus DDD pacing mode for treating sick sinus syndrome (SSS). Methods We electronically searched CENTRAL (Issue 2, 2009), MEDLINE (1980 to June 2009), EMbase (1980 to June 2009) and CBM (1990 to June 2009). Randomized controlled trials (RCTs), quasi- RCTs and cross-over studies were identified and assessed, and then RevMan 5.0 software was used to perform metaanalysis. Results A total of 509 patients of six parallel and two crossover RCTs were identified, and the quality of reporting was found poor. Studies showed a statistically significant preference to AAI pacing mode for the reduction of left atrial diameter (MD=2.09, 95%CI 0.22 to 3.97), left ventricular end-diastolic diameter (MD=3.00, 95%CI –1.58 to 7.58), the prevention atrial fibrillation (P=0.026) and the improvement of life quality (Plt;0.05), but with more replacement or remodulation. Non-significant preference was shown to the prevention of all-cause mortality (P=0.51), cardiovascular mortality (P=0.43), stroke (P=0.32) and heart failure (P=0.17), the reduction of left ventricular end-systolic diameter (MD=1.21, 95%CI –0.85 to 3.28) and left ventricular ejection fraction (MD= –2.91, 95%CI –6.53 to 0.70). No significant adverse effects were reported. Conclusion The review shows a trend towards AAI pacing mode compared with DDD pacing mode in terms of effectiveness. However, because of the high bias risk of the included trials, the evidence is insufficient, so more large-sample and high-quality RCTs are needed.
摘要:目的:了解2007~2008年成都地區17家醫院生物制品及生化藥品的使用狀況。方法:采用限定日劑量(DDD)的方法,對成都地區2007~2008年17家醫院生物制品及生化藥品的銷售金額、用藥頻度(DDDs)等進行統計分析。結果:2007年、2008年成都地區17家醫院生物制品及生化藥品銷售總額分別為7338萬元、9786萬元;分別占總銷售額的4.83%、5.00%。銷售金額進入總銷售額排名前100位的生物制品及生化藥品有:人血白蛋白、胸腺肽、丙種球蛋白、促白細胞生長素和環磷腺苷。環磷腺苷在生物制品及生化藥品中的DDDs最高。結論:生物制品及生化藥品的價格及供給對其臨床使用有較大的限制。Abstract: Objective: To evaluate the current situation and the trend of biological products and biochemical drugs used in Chengdu city in 2007 to 2008. Methods: Consumption of biological products and biochemical drugs used in 17 hospitals of Chengdu city in 2007 to 2008 were analyzed by the way of sum DDD and DDDs ranking. Results: The total cost of the biological products and biochemical drugs used in Chengdu city in was 73.38 and 97.86 million yuan in 2007 to 2008, it accounted for 4.83% and 5.00% of the total cost. Human serum albumin, thymosin, gamma globulin, interleukin promoting growth hormone and adenosine cyclophosphate were the drugs in the first 100 cost list. The DDDs of adenosine cyclophosphate was highest among biological products and biochemical drugs. Conclusion: The cost and supply of biological products and biochemical drugs were great limitations of their clinical application.
