乐卡地平与氨氯地平治疗轻中度高血压有效性与安全性的Meta分析  

The efficacy and tolerability of lercanidipine and amlodipine for mild to moderate hypertension:Meta-analysis

作　　者：冉娅娟 魏来[1] 李頔[1] 匡扶[1] 赵春景[1] 钱妍[1] 

机构地区：[1]重庆医科大学附属第二医院药学部,400010

出　　处：《重庆医学》2015年第35期4980-4984,共5页Chongqing medicine

基　　金："十二五"国家科技支撑计划基金资助项目(2013BAI06B04)

摘　　要：目的用Meta分析方法评价乐卡地平和氨氯地平治疗轻中度高血压的有效性与安全性。方法计算机检索Medline、PubMed、Embase、Cochranelibrary、Springer、Wiley、CNKI、维普和万方等数据库建库以来至2013年6月纳入二者对轻中度高血压有效性与安全性比较的临床随机对照试验（RCT）文献。通过质量评价后再提取数据采用RevMan5．0软件进行Meta分析。结果共纳入8篇质量较高的RCT文献，共计1537例患者。Meta分析结果显示，乐卡地平在治疗轻中度高血压的总有效率、迭标率、降低收缩压值和舒张压值与氨氯地平比较，差异均无统计学意义（P〉0．05）。同时安全性Meta分析结果示：乐卡地平治疗轻中度高血压总不良反应发生率、头痛发生率、面部潮红发生率与氨氯地平相当；而下肢水肿发生率[OR=0．38，95％CI（0．25～0．58），P=0．0003、因不良反应放弃治疗率[OR=0．57，95％CI（0．37～O．86），P=0．0083和因下肢水肿放弃治疗率[OR=0．24，95％CI（0．12～0．47），P=0．0003却明显低于氨氯地平。结论乐卡地平在治疗轻中度高血压的安全性和依从性方面明显优于氨氧地平。Objective To assess the efficacy and tolerability of lercanidipine versus amlodipine in the treatment of mild to moderate hypertension. Methods A systematic literature search （since build the library to June 2013） of Medline, PubMed, Embase,Cochrane library,Springer, Wiley,CNKI, VIP and Wanfang was conducted for randomized controlled trials （RCT） that compared the efficacy and tolerability of lercanidipine versus amlodipine for mild to moderate hypertension. RevMan 5.0 software was used for meta-analysis. Results A total of 8 RCT was included,involving 1 537 patients. The efficacy meta-analysis results showed that there were no statistical significance in the differences（P〉0.05） between lercanidipine group and amlodipine group in total response rate,the normalized rate, SBP and DBP decreased effect. Also compared with amlodipine, the tolerability Meta-analysis results showed that lercanidipine had the similar incidence of total adverse events, headache and flushing, but lercanidipine was associated with a more reduced risk of peripheral edema [OR = 0.38,95 % CI（O. 25 - 0.58）, P = 0. 000], a more significant reduction in risk of participants withdrawing for adverse reactions [OR=0.57,95%CI（0.37--0.86）,P=0. 008] and peripheral edema [OR= 0.24,95 % CI（0. 12-0.47）, P = 0. 000]. Conclusion Based on the current evidence, the safety and compliance of lercanidipine is better than amlodipine in the treatment of mild to moderate hypertension.

关 键 词：高血压 随机对照试验 META分析 乐卡地平 氨氯地平 

分 类 号：R544.1[医药卫生—心血管疾病]