前列地尔辅助治疗老年糖尿病肾病有效性和安全性系统评价  

Systematic Review on Efficacy and Safety of Alprostadil Injection in the Adjuvant Treatment of Elderly Diabetic Nephropathy

作　　者：黄川生[1] 张智慧[1] 王新春[1] 陈卫军[1] HUANG Chuan-sheng;ZHANG Zhi-hui;WANG Xin-chun;CHEN Wei-jun(Pharmacy Department,the First Affiliated Hospital of Shihezi University School of Medicine,Xinjiang Shihezi,832008)

机构地区：[1]石河子大学医学院第一附属医院药剂科,新疆石河子832008

出　　处：《农垦医学》2019年第6期481-488,共8页Journal of Nongken Medicine

基　　金：石河子市科技局民生与城镇化科技计划医疗卫生专项(2016HZ31)。

摘　　要：目的:评价前列地尔辅助治疗老年患者糖尿病肾病的有效性和安全性。方法:计算机检索中国知识网、万方、VIP、Pubmed、Embase、Cochrane Library和Web of Science等数据库,收集前列地尔辅助治疗老年糖尿病肾病的随机对照文献,对纳入的研究文献质量进行评价后,采用RevMan 5.3进行Meta分析。结果:纳入临床研究文献19篇,共计1546例患者,其中试验组785例,对照组761例。Meta分析结果显示:实验组总有效率[OR=7.17,95%CI(3.74,13.72),P<0.00001]、尿蛋白排泄率[SMD=-1.54,95%CI(-2.10,-0.98),P<0.00001]、血肌酐[SMD=-0.85,95%CI(-1.16,-0.53),P<0.00001]、内生肌酐清除率[SMD=1.36,95%CI(0.67,2.05),P<0.00001]、尿素氨[SMD=-0.66,95%CI(-0.94,-0.37),P<0.00001]、24h尿蛋白定量方面[SMD=-1.91,95%CI(-2.52,-1.3),P<0.00001]均优于对照组;试验组与对照组间在不良反应发生率上无显著性差异[OR=1.34,95%CI(0.90,2.00),P=0.15]。结论:前列地尔能有效改善老年糖尿病肾病患者肾功能,临床安全性较好。Objective:To evaluated the efficacy and safety of alprostadil adjunctive curing senile diabetic nephropathy.Methods:CNKI,WANFANG,VIP,Embase,Pubmed,the Cochrane Library and web of science databases were searched,which to collect randomized controlled trials(RCTs)of alprostadil curing elderly diabetic nephropathy.The quality of the qualified literature was evaluated,and then meta-analysis were performed by the RevMan5.3 software.Results:Literature includes 19 randomized controlled trials,a total of 1546 cases.Among them,785 cases belonged to the treatment group and the control group included 761.The results of meta-analyses indicated that alprostadil was superior to routine treatment in total effective rate[OR=7.17,95%CI(3.74,13.72),P<0.00001],UAE[SMD=-1.54,95%CI(-2.10,-0.98),P<0.00001],Scr[SMD=-0.85,95%CI(-1.16,-0.53),P<0.00001],Ccr[SMD=1.36,95%CI(0.67,2.05),P<0.00001],BUN[SMD=-0.66,95%CI(-0.94,-0.37),P<0.00001],24 hours urine protein[SMD=-1.91,95%CI(-2.52,-1.3),P<0.00001].All studies included did not report any significant adverse reactions.There was no statistically significant difference in adverse reactions between treatment group and control group[OR=1.34,95%CI(0.90,2.00),P=0.15].Conclusion:Alprostadil can effectively improve the renal function of elderly diabetic nephropathy patients with better clinical safety.

关 键 词：前列地尔 糖尿病肾病 老年 META分析 

分 类 号：R587.2[医药卫生—内分泌]