钠—葡萄糖协同转运蛋白-2抑制剂治疗2型糖尿病有效性和安全性的Meta分析  

Efficacy and safety of sodium glucose cotransporter-2 inhibitor in the treatment of type 2 diabetes patients:a Meta-analysis

作　　者：易金星 章陈露 江晓波 宋伟[2] YI Jinxing;ZHANG Chenlu;JIANG Xiaobo;SONG Wei(Department of Cardiology,Zhangping City Hospital,Fujian Province,Zhangping 364400,China;不详)

机构地区：[1]福建省漳平市医院心内科,364400 [2]福建省龙岩市第一医院心内科,364000

出　　处：《临床合理用药杂志》2024年第33期10-14,共5页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的系统评价钠—葡萄糖协同转运蛋白-2抑制剂(SGLT2i)治疗2型糖尿病的有效性和安全性。方法计算机检索PubMed、Cochrane Library、Embase、Web of Science及中国知网、万方数据知识服务平台上公开发表的SGLT2i治疗2型糖尿病患者有效性及安全性的随机对照试验(RCTs),文献检索时限从建库至2022年5月1日。对照组给予安慰剂治疗,试验组给予SGLT2i治疗。根据Cochrane偏倚风险评价工具对纳入文献进行质量评价,采用RevMan 5.3软件和Stata软件进行Meta分析。结果最终纳入5篇文献,共包含40205例患者,文献整体质量较高。Meta分析结果显示,与对照组相比,试验组心血管死亡或首次心力衰竭住院风险[HR=0.75,95%CI(0.61,0.92),P=0.005]、首次心力衰竭住院风险[HR=0.70,95%CI(0.60,0.82),P<0.001]显著降低,但2组心血管死亡风险[HR=0.99,95%CI(0.84,1.16),P=0.86]、全因死亡风险[HR=0.92,95%CI(0.83,1.01),P=0.09]、严重不良反应发生率[HR=1.01,95%CI(0.93,1.09),P=0.84]、急性损伤发生率[HR=0.84,95%CI(0.63,1.12),P=0.24]比较差异无统计学意义。Egger检验结果显示,报道心血管死亡或首次心力衰竭住院风险、首次心力衰竭住院风险的文献无明显发表偏倚(P值分别为0.22、0.37)。结论基于现有证据表明,SGLT2i可降低2型糖尿病患者心血管死亡或首次心力衰竭住院综合风险和首次心力衰竭住院风险,且无严重不良反应和急性肾损伤发生。Objective To evaluate the efficacy and safety of sodium glucose cotransporter-2 inhibitor(SGLT2i)in the treatment of type 2 diabetes patients by Meta-analysis.Methods PubMed,Cochrane Library,Embase,Web of Science,CNKI and WanFang Data were searched by computer to collect the RCTs of patients with type 2 diabetes who were treated with SGLT2i,the time limit for literature retrieval was from the establishment of the database to May 1,2022.The control group was given placebo treatment;The experimental group was given SGLT2i.The quality of the included literature was evaluated according to Cochrane Bias Risk Assessment Tool,and Meta-analysis was carried out by RevMan 5.3 software and Stata software.Results Finally,5 RCTs were included,with a total of 40205 patients,and with higher quality.Meta-analysis results showed that,compared with those in the control group,the experimental group showed lower comprehensive risk of first heart failure hospitalization or cardiovascular death[HR=0.75,95%CI(0.61,0.92),P=0.005]and the first heart failure hospitalization[HR=0.70,95%CI(0.60,0.82),P<0.001],but there was no significant difference in cardiovascular death[HR=0.99,95%CI(0.84,1.16),P=0.86],all-cause death[HR=0.92,95%CI(0.83,1.01),P=0.09],incidence of severe adverse reactions[HR=1.01,95%CI(0.93,1.09),P=0.84]or acute renal injury[HR=0.84,95%CI(0.63,1.12),P=0.24]between the two groups.The results of Egger test showed that,there was no obvious publication bias in the reports on cardiovascular death or hospitalization risk of first heart failure and hospitalization risk of first heart failure(P=0.22,0.37).Conclusion Based on the existing evidence,SGLT2i can reduce the comprehensive risk of first heart failure hospitalization or cardiovascular death and the first heart failure hospitalization,and without serious adverse reactions and acute kidney injury.

关 键 词：2型糖尿病 钠—葡萄糖协同转运蛋白-2抑制剂 随机对照试验 META分析 

分 类 号：R587.1[医药卫生—内分泌]