中文摘要：

目的：评价左西孟旦治疗难治性心力衰竭（RHF）的效果及安全性。方法：计算机检索PubMed、中国期刊全文数据库、万方全文数据库、中国生物医学文献数据库等有关左孟西旦与米力农治疗RHF效果的随机对照试验RCT,检索时限为建库至2015年1月,在客观评价文献质量后采用RevMan 5.3软件对纳入的试验结果进行Meta分析。结果：共纳入8篇RCT文献,共552例患者。Meta分析结果显示：有效性方面：评估心力衰竭疗效总有效率差异有统计学意义[RR=1.30,95%CI=（1.18,1.44）,P〈0.000 01];治疗前两组左室射血分数（LVEF）差异无统计学意[SMD=0.08,95%CI=（-0.12,0.27）,P〈0.000 01];治疗后与米力农组相比较,左西孟旦组LVEF有显著提高[SMD=0.53,95%CI=（0.35,0.72）,P〈0.000 01]。安全性方面：左西孟旦组和米力农组所致不良反应差异无统计学意义[RR=0.83,95%CI=（0.47,1.44）,P=0.50]。结论：左西孟旦治疗RHF的效果优于米力农,能显著提高LVEF,但两者在药物不良反应方面无统计学差异。

英文摘要：

Objective：To evaluate the efficacy and safety of levosimendan in treatment of refractory heart failure.Method：The databases of the PubMed,CNKI,Wanfang and CBM were retrieved for collecting the randomized controlled trials（RCT）about levosimendan vs milrinone in treatment of refractory heart failure from the date of establishment of the databases to January 2015.After the critical evaluation on the quality of literature,the extracted data was analyzed by RevMan 5.3software.Result：There were eight studies and 552 patients to meet the inclusion criterion.Meta-analysis showed that there were statistical differences between two groups in evaluating the total effective rate of heart failure efficacy[RR=1.30,95%CI=（1.18,1.44）,P〈0.000 01];LVEF between two groups before treatment had no statistical significance [SMD=0.08,95%CI=（-0.12,0.27）,P 0.000 01];but after the treatment,the levosimendan group had more increased on the LVEF than the milrinone group[SMD=0.53,95%CI=（0.35,0.72）,P〈0.000 01].There was no statistical significance between two groups in the incidence of side effects[RR=0.83,95%CI=（0.47,1.44）,P=0.50].Conclusion：Compared with milrinone,levosimendan may be more effective in the treatment of refractory heart failure and could significantly improve LVEF without increasing the side effects.