血管紧张素转换酶抑制剂或血管紧张素Ⅱ受体拮抗药预防高血压患者房颤发生的Meta分析  

Angiotensin-converting Enzyme Inhibitor or Angiotensin Ⅱ Receptor Blockers for Preventing Atrial Fibrillation in Hypertensive Patients:A Meta-analysis

作　　者：万里燕 崔建 李亮 魏建英 李松鹤 

机构地区：[1]清华大学第一附属医院,北京市100016

出　　处：《中国药房》2010年第42期3987-3990,共4页China Pharmacy

摘　　要：目的:对高血压患者应用血管紧张素转换酶抑制剂(ACEI)或血管紧张素Ⅱ受体拮抗药(ARB)能否预防房颤进行评价。方法:计算机检索PubMed(1980～2008年)、ScienceDirec(t1980～2008年)、Cochrane图书馆临床对照试验资料数据库(1980～2008年)、Google学术网站、中国生物医学文献数据库(1980～2008年)、中国万方数据库(1980～2008年),纳入比较ACEI或ARB与其它药治疗高血压的随机对照研究,对纳入研究的方法学质量进行评价,用RevMan5.0版软件进行统计学分析。结果:共6个随机对照研究入选,病例数总计39964例,治疗组18930例,对照组21034例。Meta分析结果显示,在高血压患者中:ACEI类药与对照组比较在预防房颤发作方面差异无统计学意义;ARB类药与对照组比较差异有统计学意义[RR合并=0.63,95%C(I0.44,0.90),P=0.01]。结论:对于高血压患者,ARB类药可降低房颤发生几率。OBJECTIVE：To evaluate the efficacy of angiotensin-converting enzyme inhibitor（ACEI）and angiotensin Ⅱ receptor blockers（ARB）in the prevention of atrial fibrillation in hypertensive patients. METHODS：Retrieved from PubMed（1980～ 2008）,ScienceDirect（1980～2008）,Cochrane Library（1980～2008）,Google Academic Website,Chinese Biomedicine Database （1980～2008）and Wanfang Database（1980～2008）,included randomized controlled trials about ACEI,ARB and other anti-hypertensive drugs in the prevention of atrial fibrillation in hypertensive patients were evaluated in methodological quality. Meta-analysis of included studies was performed by RevMan 5.0 software. RESULTS：6 randomized controlled trials that enrolled 39 964 cases met the inclusion criteria. A total of 18 930 cases received ACEI or ARB,21 034 cases received other anti-hypertensive drugs. The Meta-analysis showed no statistical significance in prevention of atrial fibrillation between ACEI and other anti-hypertensive drugs while statistical significance was noted between ARB and other anti-hypertensive drugs [RR=0.63,95%CI（0.44,0.90）,P= 0.01]. CONCLUSION：Angiotensin receptor blockers have an effect on decreasing the incidence of atrial fibrillation in patients with hypertension.

关 键 词：血管紧张素转换酶抑制剂 血管紧张素受体拮抗药 高血压 心房颤动 系统评价 

分 类 号：R972[医药卫生—药品] R969.3[医药卫生—药学]