心力衰竭中的远程监测模式:心力衰竭人群中的比较有效性 - - 一个元分析
Niels T B Scholte1, Pascal R D Clephas1, Eric Boersma1
1Department of Cardiology, Thorax Centre, Cardiovascular Institute, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands.
NPJ digital medicine
|February 10, 2026
概括
远程监控 (RM) 有效地减少了心力衰竭 (HF) 的住院和死亡率. 虽然各个患者群体的益处是一致的,但目前的证据尚未支持针对特定患者子组的目标RM实施.
科学领域:
- 心脏病学 心脏病学
- 医疗信息学 医疗信息学
- 临床试验 临床试验
背景情况:
- 远程监控 (RM) 显示出对心力衰竭 (HF) 的管理有希望.
- 对于特定的RM方式的最佳患者选择仍然不清楚.
- 需要综合证据来指导RM在HF管理中的实施.
研究的目的:
- 进行一项元分析,评估RM在减少HF住院和全因死亡率方面的有效性.
- 确定从特定的RM模式中获益最多的患者子组.
- 根据它们对HF结果的影响,对不同的RM模式进行排名.
主要方法:
- 79项随机试验的元分析,涉及31,669名患者,将RM与标准护理进行比较.
- 根据地理区域和HF状态进行子组分析.
- 超回归来评估患者特征 (年龄,LVEF,NYHA类,性别) 和出版年份的影响.
- 网络元分析以对RM模式进行排名.
主要成果:
- RM显著减少了HF住院总数 (IRR为0.81,95% CI为0.72-0.91).
- RM显著降低了首次HF住院 (RR 0.82,95% CI 0.76-0.88) 和所有原因死亡率 (RR 0.90,95% CI 0.84-0.95).
- 侵入性血液动力学监测在减少HF住院总数方面排名最高;结构化电话支持在首次HF住院和全因死亡率方面排名最高.
结论:
- 远程监测在不同患者和研究特征中持续改善心力衰竭结果.
- 支持RM在心力衰竭管理中的广泛适用性.
- 目前的证据不允许有针对性的RM实施,以确定最受益的特定患者子组.
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