血管紧张素转换酶抑制剂和血管紧张素Ⅱ受体拮抗剂对高血压患者血管僵硬度作用差异的Meta分析  

Meta-analysis of the Different Effects of Angiotensin Converting Enzyme Inhibitor and Angiotonin Ⅱ Receptor Blocker on Vascular Stiffness in Hypertensive Patients

作　　者：张艺军[1] 刘城[2] 吴平生[3] 钟武装[1] 

机构地区：[1]广州军区广州总医院干部病房二科,广东省广州市510010 [2]广州市第一人民医院心血管内科 [3]南方医科大学南方医院心血管内科

出　　处：《中国全科医学》2012年第33期3823-3826,共4页Chinese General Practice

基　　金：国家自然科学基金青年基金项目(30900659);广东省自然科学基金项目(S2011040004458)

摘　　要：目的系统评价血管紧张素转换酶抑制剂(ACEI)和血管紧张素Ⅱ受体拮抗剂(ARB)对高血压患者动脉僵硬度作用的差异。方法计算机检索Cochrane图书馆临床对照试验资料库(CCRCT)、PubMed、EMBase、万方数据库、中国学术期刊全文数据库(CNKI)、中国生物医学文献数据库(CBMdisc)、维普数据库(VIP)。检索时间为各数据库建库至2012年1月。纳入采用ACEI或ARB治疗原发性高血压患者的随机对照试验(RCT),采用RevMan5.0软件进行统计分析。比较ACEI和ARB对高血压患者脉搏波传导速度、收缩压、舒张压等指标的影响。结果共检索到相关文献833篇,初筛后收集到符合标准的文献51篇,进一步筛选纳入6项RCT,共计231例患者。Meta分析结果表明,ACEI在改善动脉僵硬度方面优于ARB,差异有统计学意义〔肱-踝脉搏波速度差(ΔbaPWV)=-113.53,95%CI(-152.21,-74.84)〕。但收缩压和舒张压降低程度间差异均无统计学意义〔收缩压差(ΔSBP)=2.09,95%CI(-2.50,6.67),P=0.37;舒张压差(ΔDBP)=1.75,95%CI(-1.55,5.04),P=0.30〕。结论 ACEI在改善高血压患者动脉僵硬度方面优于ARB。Objective To evaluate the differences in the effects of angiotensin converting enzyme inhibitor(ACEI) and angiotensin Ⅱ receptor blocker(ARB) on arterial stiffness in hypertensive patients.Methods We searched databases for the randomized controlled trials(RCTs) which compared the effects of ACEI and ARB on arterial stiffness in hypertensive patients up to January 2012,and analyzed the data by Cochrane Collaboration′s RevMan 5.0 software.Results A total of 6 elegible RCTs were included for meta analysis,which demonstrated that there was a significant difference between the effects of ACEI and ARB on vascular stiffness.ACEI was significantly superior to ARB in improving vascular stiffness(ΔbaPWV=-113.53,95%CI(-152.21,-74.84));However,these two drugs showed no significant difference in lowering either systolic blood pressure(ΔSBP=2.09,95%CI(-2.50,6.67),P=0.37)or diastolic blood pressure(ΔDBP=1.75,95%CI(-1.55,5.04),P=0.30).Conclusion ACEI is superior to ARB in improving vascular stiffness in hypertensive patients.

关 键 词：血管紧张转换酶抑制剂 血管紧张素Ⅱ受体拮抗剂 高血压 META分析 

分 类 号：R544.1[医药卫生—心血管疾病]