别嘌呤醇治疗慢性肾脏病疗效和安全性的meta分析  

Efficacy and safety of allopurinol in the treatment of chronic kidney disease:a meta-analysis

作　　者：刘顺瑶 鄂静[2] 罗红艳[2] 保莉[2] 田文竹 包喜 曹释露 郑亚莉[2] Liu Shunyao;E Jing;Luo Hongyan;Bao Li;Tian Wenzhu;Bao Xi;Cao Shilu;Zheng Yali(Ningxia Medical University,Yinchuan 750000,China;Department of Nephrology,the People′s Hospital of Ningxia Hui Autonomous Region,Yinchuan 750000,China)

机构地区：[1]宁夏医科大学,银川750000 [2]宁夏回族自治区人民医院肾脏内科,银川750000

出　　处：《中国医师杂志》2022年第4期505-511,共7页Journal of Chinese Physician

基　　金：国家自然科学基金(81860136);宁夏自然科学基金(2020AAC03332)。

摘　　要：目的系统评价别嘌呤醇治疗慢性肾脏病的疗效和安全性。方法计算机检索Embase、Pubmed和The Cochrane Library数据库,查找别嘌呤醇治疗慢性肾脏病患者的随机对照试验。根据Cochrane系统评价方法,两位评价员独立筛选文献、提取数据,采用Revman 5.3软件进行结果分析。结果最终纳入10篇文献,共940例患者(试验组472例,对照组468例)。Meta分析结果显示,别嘌呤醇治疗可以降低慢性肾脏病患者的血尿酸(MD=-2.40,95%CI:-2.74--2.05,P<0.01)、24 h尿蛋白(MD=-0.61,95%CI:-1.17--0.06,P=0.03),升高肾小球滤过率估算值(eGFR)(MD=2.51,95%CI:1.86-3.17,P<0.01)。试验组和对照组发生不良事件的差异无统计学意义(OR=1.40,95%CI:0.61-3.19,P=0.42),但别嘌呤醇治疗可以降低心血管事件的发生风险(OR=0.58,95%CI:0.38-0.89,P=0.01)。结论别嘌呤醇治疗慢性肾脏病会降低尿蛋白、改善eGFR,并且降低心血管事件的发生风险。Objective To evaluate the efficacy and safety of allopurinol in the treatment of chronic kidney disease.Methods The databases of Embase,PubMed and the Cochrane library were searched for randomized controlled trials of allopurinol in patients with chronic kidney disease.According to the Cochrane system evaluation method,two evaluators independently screened the literature and extracted the data,and analyzed the results with Revman 5.3 software.Results Finally,10 articles were included,including 940 patients(472 in the experimental group and 468 in the control group).Meta analysis showed that allopurinol treatment could reduce blood uric acid(MD=-2.40,95%CI:-2.74--2.05,P<0.01),24-hour urinary protein(MD=-0.61,95%CI:-1.17--0.06,P=0.03)and increase estimation of glomerular filtration rate(eGFR)(MD=2.51,95%CI:1.86-3.17,P<0.01).There was no significant difference in adverse events between the experimental group and the control group(OR=1.40,95%CI:0.61-3.19,P=0.42),but allopurinol treatment could reduce the risk of cardiovascular events(OR=0.58,95%CI:0.38-0.89,P=0.01).Conclusions Allopurinol treatment of chronic kidney disease can reduce urinary protein,improve eGFR,and reduce the risk of cardiovascular events.

关 键 词：肾功能不全 慢性 别嘌呤醇 META分析 

分 类 号：R692[医药卫生—泌尿科学]