格列吡嗪对比瑞格列奈治疗2型糖尿病疗效和安全性的Meta分析  

Meta-analysis of the Efficacy and Safety of Glipizide versus Repaglinide in Treatment of Type 2 Diabetes

作　　者：李莎[1] 王芳[1] 房秀梅[1] 唐亮[1] 王晓燕[1] 

机构地区：[1]解放军总医院第一附属医院药剂药理科,北京100071

出　　处：《中国药房》2015年第18期2517-2520,共4页China Pharmacy

基　　金：国家科技支撑计划子课题(No.2013BAI06B04Y023-129)

摘　　要：目的:系统评价格列吡嗪对比瑞格列奈治疗2型糖尿病的疗效和安全性,以为临床治疗提供循证参考。方法:计算机检索Pub Med、EMBase、Medline、Cochrane图书馆、中国期刊全文数据库、中文科技期刊全文数据库和万方数字化期刊全文数据库,收集格列吡嗪(试验组)对比瑞格列奈(对照组)治疗2型糖尿病疗效和安全性的随机对照试验(RCT),对符合纳入标准的临床研究进行质量评价和资料提取后,采用Rev Man 5.2统计软件进行Meta分析。结果:共纳入10项RCT,合计1 022例患者。Meta分析结果显示,试验组患者糖化血红蛋白水平[MD=0.43,95%CI(0.20,0.65),P<0.001]、餐后2 h血糖水平[MD=0.49,95%CI(0.04,0.94),P=0.03]和低血糖发生率[OR=2.99,95%CI(1.83,4.88),P<0.001]均显著高于对照组,而两组患者空腹血糖水平比较差异无统计学意义[MD=-0.14,95%CI(-0.44,0.16),P=0.35]。结论:瑞格列奈治疗2型糖尿病疗效和安全性优于格列吡嗪。受纳入研究方法学质量和样本量限制,该结论有待更多设计严格、长期随访的大样本RCT加以验证。OBJECTIVE：To systematically review the efficacy and safety of glipiaide versus repaglinide in treatment of type 2diabetes and provide evidence-based reference for the clinical treatment. METHODS：Pub Med,EMBase,Medline,Cochrane Library,CJFD,VIP and Wan Fang database were retrieved to collect the randomized controlled trials（RCT）of the efficacy and safety of glipizide（test group）versus repaglinide（control group）in the treatment of type 2 diabetes. After the quality evaluation and information collection of clinical studies with inclusion criteria,Rev Man 5.2 software was conducted for Meta-analysis. RESULTS：There were totally 10 RCTs,involving 1 022 patients. Meta-analysis results showed that the Hb A1 c levels [MD=0.43,95% CI（0.20,0.65）,P〈0.001],2 h postprandial plasma glucose levels [MD=0.49,95% CI（0.04,0.94）,P=0.03] and hypoglycemia incidence [OR=2.99,95%CI（1.83,4.88）,P〈0.001] in test group were significantly higher than control group. There was no significant difference in the fasting plasma glucose level in 2 groups[MD=-0.14,95%CI（-0.44,0.16）,P=0.35]. CONCLUSIONS：Repaglinide has better efficacy and safety than glipizide in the treatment of type 2 diabetes. Limited by the methodological quality and sample amount of included studies,it remains to be verified by RCT with large sample,strict design and long-term follow-up.

关 键 词：格列吡嗪 瑞格列奈 2型糖尿病 META分析 疗效 安全性 

分 类 号：R977.6[医药卫生—药品]