他汀类药物对心血管疾病患者肾功能影响的系统评价  

Systematic Evaluation of Effects of Statins on Renal Function in Patients with Cardiovascular Disease

作　　者：洪卫兰[1] HONG Weilan(Dept.of Pharmacy,Zhongshan People's Hospital,Guangdong Zhongshan 528400,China)

机构地区：[1]中山市人民医院药学部,广东中山528400

出　　处：《中国医院用药评价与分析》2019年第1期69-71,75,共4页Evaluation and Analysis of Drug-use in Hospitals of China

摘　　要：目的:系统评价他汀类药物对心血管疾病患者肾功能的影响。方法:检索中国知网、EMBase、Medline、维普数据库及万方数据库,按照纳入标准筛选他汀类药物治疗心血管疾病的随机对照试验[观察组采用他汀类药物治疗,对照组采取常规治疗或未应用他汀类药物治疗,文献需含有患者治疗前后肾小球滤过率(eGFR)的数据],检索时限从2011年1月1日至2018年8月1日;提取数据并进行方法学质量评价后,采用Stata 12.0软件进行文献荟萃分析(Meta分析)。结果:共纳入12篇文献,均为随机对照试验,各研究间不存在异质性。Meta分析结果显示,观察组患者的治疗前后eGFR变化值明显优于对照组,差异有统计学意义(MD=0.11,95%CI=0.02～0.20,P=0.01);亚组分析结果显示,观察组中长时间(>6个月)服用他汀类药物患者治疗前后eGFR变化值明显优于对照组,差异有统计学意义(MD=0.12,95%CI=0.01～0.22,P=0.03),但观察组中短期(≤6个月)服用他汀类药物患者治疗前后eGFR变化值与对照组的差异无统计学意义(MD=0.10,95%CI=-0.06～0.26,P=0.21)。结论:他汀类药物对心血管疾病患者的肾功能具有一定的保护作用,且此作用在长期服用他汀类药物治疗中更为明显。OBJECTIVE:To evaluate the effects of statins on renal function in patients with cardiovascular disease.METHODS:CNKI,EMBase,Medline,VIP and Wanfang database were retrieved to collected randomized controlled trials(RCT)of statins for cardiovascular disease according to inclusion criteria[the observation group was treated with statins,the control group received conventional treatment or no statins therapy,literature should include data on glomerular filtration rate(eGFR)before and after treatment]from Jan.1st,2011 to Aug.1st,2018.After data extraction and methodological quality evaluation,meta-analysis(Meta analysis)of the literature was performed using Stata 12.0 software.RESULTS:A total of 12 literature were included,all of which were randomized controlled trials.There was no heterogeneity among the studies.Meta-analysis showed that after treatment,the changes of eGFR before and after treatmen in the observation group was significantly better than that in the control group,and the difference was statistically significant(MD=0.11,95%CI=0.02-0.20,P=0.01).Subgroup analysis showed that the changes of eGFR before and after treatmen of patients taking statins for a long time( >6 months)in the observation group was significantly better than that of the control group,the difference was statistically significant(MD=0.12,95%CI=0.01-0.22,P=0.03),yet there was no significant difference in the changes of eGFR before and after treatmen between patients taking statins for a short term(≤6 months)in the observation group and the control group(MD=0.10,95%CI=-0.06-0.26,P=0.21).CONCLUSIONS:Statins have a protective effect on renal function in patients with cardiovascular disease,and the effect is more pronounced in long-term statin therapy.

关 键 词：心血管疾病 他汀类药物 肾功能 Meta分析 

分 类 号：R972.6[医药卫生—药品]