达卢生坦治疗顽固性高血压疗效与安全性的Meta分析  

A Meta Analysis on Effectiveness and Safety of Darusentan Treatment for Resistant Hypertension

作　　者：方奇[1] 方冬[1] 彭松[1] 万静[1] 

机构地区：[1]武汉大学中南医院心内科,湖北武汉430071

出　　处：《武汉大学学报（医学版）》2015年第3期488-493,共6页Medical Journal of Wuhan University

摘　　要：目的:评价达卢生坦治疗顽固性高血压的疗效与安全性。方法:在PubMed、EMbase和Cochrane library中检索2013年12月之前所有关于达卢生坦治疗顽固性高血压的随机对照试验。由两名研究者根据纳入与排除标准独立筛选文献、提取资料和评价纳入研究的方法学质量。应用Review manager 5.2软件进行Meta分析。结果:共纳入文献有3篇,共计978例顽固性高血压患者,其中687例在试验组,291例在对照组。Meta分析结果显示,与对照组相比,达卢生坦治疗组收缩压下降7.44mmHg(95%CI:-11.56--3.31,P<0.05),舒张压下降4.64mmHg(95%CI:-6.36-2.91,P<0.05),明显提高收缩压达标率[相对危险度RR=1.62(95%CI1.22-2.14,P<0.05)]。安全性方面,常见不良反应水肿、疲乏发生率有所升高(水肿RR=2.10,95%CI:1.60-2.74,P<0.05;疲乏RR=2.50,95%CI:1.14-5.48,P<0.05)。头晕、头痛、死亡的发生率无明显差异[头晕RR=1.13(95%CI:0.63-2.02,P=0.67),头痛RR=1.47(95%CI:0.83-2.60,P=0.19),死亡RR=0.57(95%CI:0.13-2.47,P=0.45)]。结论:目前的数据表明达卢生坦治疗顽固性高血压具有相对较好的疗效与安全性。Objective：To systematically review the effectiveness and safety of darusentan for resistant hypertension.Methods：Databases including PubMed,EMbase,the Cochrane Library were electronically searched for all randomized controlled trials（RCTs）about using darusentan treatment in patients with resistant hypertension before December 2013.According to the inclusion and exclusion criteria,two reviewers independently screened literature,extracted data and assessed the methodologically quality of the included studies.Then,meta-analysis was performed using RevMan5.2software.Results：Three RCTs involving 978（687patients in experiment group and 291 patients in control group）patients with resistant hypertension were finally included.Compared with controlled group,systolic blood pressure（SBP）reduced by 7.44mmHg（95%CI：-11.56--3.31 P〈0.05）and diastolic blood pressure（DBP）reduced by 4.64mmHg（95%CI：-6.36--2.91 P〈0.05）.In addition,the incidence of controlled rate of systolic blood pressure significantly increased（RR=1.62;95%CI：1.22-2.14,P〈0.05）.For safety,compared with controlled group,the incidence of the most common adverse event edema was higher（RR=2.10;95%CI：1.60-2.74;P〈0.05）,as well as fatigue（RR=2.50;95%CI：1.14-5.48,P〈0.05）.But for the dizziness,headache and mortality,there were no significant differences between the two group（dizziness：RR=1.13,95%CI：0.63-2.02,P=0.67;headache：RR=1.47,95%CI：0.79-2.47,P=0.25;mortality：RR=0.57,95%CI：0.13-2.47,P=0.45）.Conclusion：Darusentan treatment for resistant hypertension has a relatively good effectiveness and safety from current data.

关 键 词：顽固性高血压 达卢生坦 META分析 

分 类 号：R544.1[医药卫生—心血管疾病]