Drugs For High Altitude Pulmonary Hypertension :a System Evaluation And Meta-analysis

Objective:This study performed a system evaluation to explore the prevention of drugs for high altitude pulmonary hypertension.Methods:Cochrane library,Pub Med, Elsevise,CNKI,Wanfang and Vip databases were searched for some randomized controlled trials and extracted data which were published in Chinese and English on medication to prevent altitude pulmonary. Rev Man 5. 2 software was used to conduct Meta-analysis to which meet the inclusion criteria in the fixed effects model or random effects model.Results :(1) A total of 13 articles were included in this study,and 9 of those related to phosphodiesterase type 5 inhibitors to prevent altitude pulmonary hypertension,other 4 articles bosentan-related.There were 185 cases of patients in the Experimental group,and 168 cases in the placebo group.(2.)The analysis showed that there was a significantly difference between type 5phosphodiesterase inhibitors and placebo in the prevention aspect of pulmonary artery pressure increasing 〔WMD =-6. 07,95% CI(-8. 81,-4. 40),P < 0. 000 01〕, and there was no difference between the Bosentan and placebo in preventing pulmonary artery pressure increasing〔WMD =-2. 39,95% CI(-6.49,1. 68),P = 0. 33〕.(3)The analasis also showed that there was no difference between type 5 inhibitors compared with placebo in effects on cardiac output orientation〔WMD=0.56,95% CI(-0.32,1.45),P>0.05).(4)The analysis showed that there was no difference between type 5 inhibitor and placebo on blood pressure,this trend also appeared in the comparison between bosentan group and bosentan group〔WMD=-1.14,95% CI(-6.38,4.01),P>0.05〕〔WMD=-2.83,95% CI(-8.23,2.56),P>0.05〕.(5)The analysis showed that there was no difference between type 5 inhibitor and placebo on heart beats,this trend also appeared in the comparison between bosentan group and bosentan group〔WMD=2.49,95% CI(-4.17,9.15),P>0.05〕〔WMD=1.72,95% CI(-2.86,6.34),P>0.05〕.(6)The analysis showed that there was no difference between type 5 inhibitor and placebo on the oxygen saturation,this trend also appeared in the comparison between bosentan group and bosentan group〔WMD=0.61,95% CI(-1.71,2.93),P>0.05〕〔WMD=-0.32,95% CI(-2.31,1.66),P>0.05〕.Conclusion: Evidence from the current point of view: 1.When compared with placebo group,type 5 phosphodiesterase inhibitors was effetely in preventing the increasing of pulmonary artery pressure of the population in low-altitude exposure to elevated plateau environment, and cardiac output, heart rate, blood pressure, oxygen saturation had no significant difference.2. When compared with placebo group, the affection of bosentan group in preventing the increasing ofpulmonary artery pressure of the population in low-altitude exposure to elevated plateau environment was not obvious, and cardiac output, heart rate, blood pressure, oxygen saturation had no significant difference.