苯二氮䓬类药物对心力衰竭结局和不良事件的影响：系统综述与Meta分析。
完整摘要 · 中文译文
苯二氮䓬类药物（BZDs）治疗失眠对心力衰竭（HF）的影响仍不清楚，尤其是在高风险人群中。通过检索7个数据库自建库至2025年8月7日的文献获取相关研究。提取了针对相关HF结局估计的风险比（HRs）或危险比。使用随机效应模型进行荟萃分析，并使用纽卡斯尔-渥太华量表（NOS）评估研究质量。11项研究符合纳入标准，随访时间范围为180天至15年。荟萃分析表明，与未使用相比，使用BZD与HF发生率（HR = 1.41，95%置信区间（CI）1.16-1.72）和HF住院（HR = 1.29，95% CI 1.01-1.65）风险增加相关。与抗精神病药、Z类药物和苏沃雷生相比，使用BZD也提示HF住院和再住院风险增加。苯二氮䓬类药物使用与HF相关结局风险增加相关。由于纳入的大多数研究为观察性研究，这些发现表明的是相关性而非因果关系。对于有HF风险的人群，治疗失眠时应慎用BZDs。
完整摘要 · 英文原文
The effects of benzodiazepines (BZDs) for insomnia on heart failure (HF) remain unclear, particularly among high-risk populations. Relevant studies were retrieved by searching seven databases from inception to August 7, 2025. Hazard ratios (HRs) or risk ratios estimated for related HF outcomes were extracted. Meta-analyses were conducted using a random-effects model, and study quality was assessed using the Newcastle-Ottawa Scale (NOS). Eleven studies met the inclusion criteria, with follow-up durations ranging from 180 days to 15 years. The meta-analysis demonstrated that BZD use was associated with increased risks of HF incidence (HR = 1.41, 95% confidence interval (CI) 1.16-1.72) and HF hospitalization (HR = 1.29, 95% CI 1.01-1.65) compared to non-use. BZD use also suggested an increased risk of HF hospitalization and rehospitalization compared to antipsychotics, z-drugs, and suvorexant. Benzodiazepine use was associated with an increased risk of HF-related outcomes. Since most of the included studies were observational, these findings indicate associations rather than causal relationships. BZDs should be used with caution among populations at risk of HF when treating insomnia.