尼可地尔治疗不稳定型心绞痛疗效和安全性的Meta分析  

Curative effect and safety of nicorandil in treatment of unstable angina pectoris:a Meta-analysis

作　　者：赵明明[1] 王海蓉[1] 熊峰[1] 聂晨[1] 周游[1] 

机构地区：[1]武汉大学中南医院心内科,武汉430071

出　　处：《中国循证心血管医学杂志》2014年第2期131-135,共5页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的系统评价尼可地尔治疗不稳定型心绞痛的疗效和安全性。方法计算机检索Cochrane图书馆临床对照试验资料库、PubMed、EMbase、万方、维普数据库、中国知网、中国生物医学文献服务系统（CBM）。收集尼可地尔治疗不稳定型心绞痛的临床随机对照试验。按照纳入和排除标准,由3名研究者独立筛选试验、提取资料、评估方法学质量。交叉核对后,使用RevMan5.1软件进行Meta分析。结果共纳入12个随机对照试验,1002例患者。Meta分析结果显示在治疗不稳定型心绞痛有效性方面,尼可地尔优于硝酸酯类药物,差异具有统计学意义（RR=1.23,95%CI：1.13～1.35）。在改善心电图表现方面,尼可地尔优于硝酸酯类药物,差异有统计学意义（RR=1.74,95%CI：1.43～2.12）。在不良反应发生率方面,尼可地尔与硝酸酯类药物相比,差异无统计学意义（RR=0.71,95%CI：0.50～1.02）。结论在治疗不稳定型心绞痛临床疗效方面,尼可地尔不逊于硝酸酯类药物,且不良反应发生率低。但由于本研究所纳入研究样本量少、方法学质量偏低,疗程不一致且皆为国内研究,所以本研究结论应谨慎接受。Objective To review systematically the curative effect and safety of nicorandil in treatment of unstable angina pectoris （UAP）. Methods The databases of Cochrane Controlled Trials Register, PubMed, EMbase, WanFang Database, VIP Database, CNKI and CBM were retrieved with computer for collecting clinical randomized controlled trials （RCT） about treatment of UAP with nicorandil. According to inclusion and exclusion criteria, 3 researchers screened RCT, extracted data and review the quality of methodology independently. After cross checking, RevMan5.1 software was used for a Meta-analysis. Results There were totally 12 RCT included involving 1002 patients, and the results of Meta-analysis showed that nicorandil was better than nitrates in the aspect of curative effect on UAP （RR=1.23, 95%CI：1.13-1.35） and in the aspect of improving ECG （RR=1.74, 95%CI：1.43-2.12）, and had no statistical significance in the aspect of incidence of adverse reactions （RR=0.71, 95%CI：0.50-1.02）. Conclusion Nicorandil is similar to nitrates in the aspect of curative effect on UAP with lower incidence of adverse reactions. As the study included less samples, methodological quality was lower and therapeutic courses were not the same, the conclusion should be cautiously accepted.

关 键 词：尼可地尔 硝酸甘油 单硝酸异山梨酯 硝酸异山梨酯 不稳定型心绞痛 META分析 

分 类 号：R541.4[医药卫生—心血管疾病]