SGLT2抑制剂对2型糖尿病合并心血管疾病患者心血管不良事件影响的meta分析与试验序贯分析  

Meta-analysis and trial sequential analysis of the effects of SGLT2 inhibitors on cardiovascular adverse events in type 2 diabetes mellitus patients with cardiovascular disease

作　　者：周欣荣[1] 李艳[1] 朱嘉俊[1] 王宁[2] ZHOU Xinrong;LI Yan;ZHU Jiajun;WANG Ning(Cardiovascular Center Intensive Care Unit,the First Affiliated Hospital of Xinjiang Medical University,Xinjiang Uygur Autonomous Region,Urumqi 830054,China;Department of General Second Internal Medicine,the First Affiliated Hospital of Xinjiang Medical University,Xinjiang Uygur Autonomous Region,Urumqi 830054,China)

机构地区：[1]新疆医科大学第一附属医院心血管病中心监护室,新疆乌鲁木齐830054 [2]新疆医科大学第一附属医院综合内二科,新疆乌鲁木齐830054

出　　处：《中国医药导报》2022年第8期64-68,共5页China Medical Herald

基　　金：省部共建中亚高发病成因与防治国家重点实验室开放课题项目(SKL-HIDCA-2020-19)。

摘　　要：目的评估钠-葡萄糖耦联转运体2(SGLT2)抑制剂对2型糖尿病合并心血管疾病患者心血管不良事件的影响。方法检索PubMed、Cochrane Library、Google Scholar、万方数据库、中国知网、中国生物医学数据库,查找有关SGLT2抑制剂对2型糖尿病合并心血管疾病患者心血管不良事件影响的随机对照试验(RCT),检索时限为建库至2021年4月。分别采用RevMan、TSA软件及GRADE pro进行meta分析、试验序贯分析及证据质量评价。结果最终纳入6项RCT,共计30534例患者。meta分析结果显示,SGLT2抑制剂组心血管病死亡率(RR=0.84,95%CI:0.72~0.99,P=0.03)、因心力衰竭入院率(RR=0.67,95%CI:0.60~0.73,P<0.00001)、全因死亡率(RR=0.85,95%CI:0.78~0.92,P<0.0001)低于安慰剂组。GRADE证据质量评价结果显示meta分析结果质量等级均为“高”。试验序贯分析结果显示meta分析结果得到了相对肯定的结论且不需要更多试验加以证明。结论SGLT2抑制剂对2型糖尿病合并心血管疾病患者能够发挥良好的心脏保护作用。Objective To evaluate the effects of sodium-glucose linked transporter 2(SGLT2)inhibitors on cardiovascular adverse events in type 2 diabetes mellitus patients with cardiovascular disease.Methods PubMed,Cochrane Library,Google Scholar,Wanfang Data,CNKI,and Chinese Biomedical Database were searched for randomized controlled trial(RCT)on the effects of SGLT2 inhibitors on cardiovascular adverse events in type 2 diabetes mellitus patients with cardiovascular disease.The retrieval period is from the inception to April 2021.Meta-analysis,sequential analysis,and evidence quality evaluation were performed by RevMan,TSA,and GRADE pro,respectively.Results Six RCTs were included,with a total of 30534 patients.Meta-analysis showed that cardiovascular mortality rate(RR=0.84,95%CI:0.72-0.99,P=0.03),hospitalization rate for heart failure(RR=0.67,95%CI:0.60-0.73,P<0.00001),and all-cause mortality(RR=0.85,95%CI:0.78-0.92,P<0.0001)were lower than those in placebo group.GRADE evidence quality evaluation results showed that the quality GRADE of meta-analysis results was“high”.The sequential analysis results showed that the meta-analysis results were relatively positive and did not need to be proved by more experiments.Conclusion SGLT2 inhibitors plays a good cardioprotective role in type 2 diabetes mellitus patients with cardiovascular disease.

关 键 词：钠-葡萄糖耦联转运体2抑制剂 2型糖尿病 心血管疾病 meta分析 

分 类 号：R54[医药卫生—心血管疾病]