烟酸及烟酰胺对维持性透析患者血磷影响的系统评价  

Effect of nicotinic acid and nicotinamide on serum phosphate level in dialysis patients: a systematic

作　　者：王沫[1] 何辉[1] 刘丁[1] 胡建敏[1] 郭颖[1] 

机构地区：[1]南方医科大学珠江医院器官移植科,广州510282

出　　处：《中国血液净化》2014年第3期146-151,共6页Chinese Journal of Blood Purification

摘　　要：目的评价应用烟酸及烟酰胺治疗维持性透析患者高磷血症的疗效及安全性。方法运用Cochrane图书馆、PubMed、EMbase、中国期刊全文数据库(CNKI)、万方数据库和维普期刊数据库检索使用烟酸或烟酰胺治疗维持性透析患者高磷血症的临床试验,经过质量评估和数据提取,对符合标准的研究进行系统评价。结果 13项研究中共有328名维持性透析患者(13例为腹膜透析患者,其余均为血液透析患者)入选,Meta分析结果显示治疗组/用药后同对照组/用药前相比,血磷、钙磷乘积的下降具有统计学意义,而血钙、甲状旁腺激素及血小板计数的变化不具有统计学意义。结论目前证据显示,烟酸及烟酰胺可降低维持性透析患者的血磷,临床使用安全有效。但因纳入文献的质量和样本量有限,因此需要大样本及高质量的临床试验来提供更好的循证证据。Objective We performed meta-analysis to assess the effect and safety of nicotinic acid and nicotinamide for the treatment of hyperphosphatemia in dialysis patients. Methods Cochrane Library, PubMed, EMbase, CNKI, Wanfang Database and Weipu Database were searched for literature about clinical trials on nicotinic acid/nicotinamide treatment for hyperphosphatemia in dialysis patients. After quality assess- ment and data extraction, meta-analysis was conducted for the clinical trials consistent with the standards. Re- suits A total of 328 maintenance dialysis patients （I 3 cases on peritoneal dialysis and 315 cases on hemodial- ysis） in the 13 reports were analyzed. Meta-analysis showed that serum phosphate and calcium-phosphorus product decreased significantly after the treatment of nicotinic acid and nicotinamide, and there were no statis- tically differences in serum calcium, iPTH and platelet count between treatment （or post-treatment） group and control （or pre-treatment） group. Conclusion The current data in literature indicate that nicotinic acid and nic- otinamide are effective and safe in controlling serum phosphate in dialysis patients. However, this conclusion has to be confirmed by strictly designed and large clinical trials.

关 键 词：烟酸 烟酰胺 维持性透析 高磷血症 Meta分析 

分 类 号：R459.5[医药卫生—治疗学]