阿格列汀治疗2型糖尿病的系统评价  

Alogliptin in the treatment of type 2 diabetes:a Meta-analysis of randomized controlled trails

作　　者：王瑜[1,2] 胡明[1] 占美[2] 代国友[2] 程艳霞[2] 苏娜[2] 方煜[1] 

机构地区：[1]四川大学华西药学院,四川成都610041 [2]四川大学华西医院,四川成都610041

出　　处：《中国医院药学杂志》2014年第23期2014-2022,共9页Chinese Journal of Hospital Pharmacy

摘　　要：目的:系统评价阿格列汀治疗2型糖尿病的有效性和安全性。方法:计算机检索Cochrane Library、PubMed、EMbase、CBM、VIP和CNKI数据库,检索时限截至2013年12月,获得阿格列汀与空白对照或其他阳性药物比较治疗2型糖尿病的随机对照试验(RCT),由两位研究者根据纳入与排除标准筛选试验、提取资料、开展质量评价并交叉核对结果,采用RevMan 5.2软件进行Meta分析。结果:共纳入10篇RCT,含5 154名受试者。Meta分析结果显示:在降低患者糖化血红蛋白(HbA1c)水平方面阿格列汀组明显优于对照组,且差异具有统计学意义[MD=-0.73,95%CI(-0.84,-0.61),P<0.000 01];在控制患者体质量方面对照组优于阿格列汀组,且差异具有统计学意义[MD=0.41,95%CI(0.26,0.55),P<0.000 01];阿格列汀组不良事件及严重不良事件发生率与对照组相似,2组差异无统计学意义;阿格列汀组的低血糖、高血压、鼻咽炎、上呼吸道感染、头痛事件的发生率与对照组比较无统计学意义。结论:阿格列汀治疗2型糖尿病疗效确切,安全性较好。受限于纳入研究数量,上述结果有待更多的大样本长期随访研究予以验证。OBJECTIVE To evaluate the efficacy and safety of alogliptin for patients with type 2 diabetes. METHODS The Cochrane Library, PuhMed, EMhase, CBM, VIP and CNKI were searched from inception to Dec. 2013 to collect the random- ized controlled trials （RCTs） of alogliptin vs blank control or other positive control drug in treating type 2 diabetes. Two re- viewers screened the trials according to the inclusion and exclusion criteria, extracted the data, assessed the quality in accord- ance with the Coehrane Collaboration, and conducted meta-analyses with RevMan 5. 2 software. RESULTS A total 10 trials in- volving 5154 patients were included. The results of meta-analyses showed that the alogliptin produced greater reduction in HbAlc compared with controls （MD= - 0. 73,95% CI - 0. 84 to - 0. 61, P〈0. 000 0l）, but it was inferior to the control in losing weight （MD= 0. 41, 95% CI 0. 26 to 0. 55, P〈0. 000 01）, and there was no statistically significant difference between alogliptin and controls in AEs, SAE, hypoglycaernia, hypertension, nasopharyngitis, upper respiratory tract infection and headache. CONCLUSION The alogliptin treatment for type 2 diabetes is effective and safe. However, due to the limited quan- tity of the studies, more longer-term studies with large scale and long-term follow-up are still needed to verify the above conclu- sion.

关 键 词：阿格列汀 2型糖尿病 META分析 系统评价 

分 类 号：R977.15[医药卫生—药品]