他汀类药物对心血管疾病患者肾保护作用的meta分析

摘要

Objective:To evaluate the effects of statins on renal function in patients with cardiovascular diseases.Methods: We searched PubMed, EMbase, as well as CENTRAL database for randomized controlled trials and clinical controlled trial. Studies reporting GFR during treatment with statins compared to control (placebo, no statins, or usual care) were included. We assessed statistical heterogeneity withI2 index and pooled the results with random-effects model. The standardized mean differences (SMD) were measured respectively to analyze GFR. Meta-analysis were performed by Cochrane Collaboration’s RevMan 5.2 software.Results:6 RCTs and 1 CCT met the inclusion criteria.compared with control group, changes in the SMD of GFR were 0.82 [95%CI(0.37, 1.27),P=0.000 4] for statins; The results of subgroup analysis showed that compared with control group, changes in the SMD of GFR were 1.87 [95%CI (1.05, 2.69),P60 mL•min-1•1.73 m-2).%目的：评价他汀类对心血管疾病患者肾功能的影响。方法：利用数据库PubMed，EMbase，以及CENTRAL筛选出以他汀治疗为试验组，以安慰剂、未使用他汀类药物或者常规治疗为对照组的随机对照试验或临床对照试验，这些试验需提供受试者治疗前后的肾小球滤过率（glomerular filtration rate，GFR）的相关数据。用I2值表示异质性的大小，并用随机效应模型合并数据，用标准化均数差（SMD）作为比较GFR的效应值，并用RevMan 5.2软件进行数据分析。结果：共纳入7篇符合条件的对照试验，结果显示他汀治疗组与对照组相比，可提高GFR，治疗前后GFR差值的SMD为0.82[95%CI（0.37，1.27），P=0.0004]；亚组分析显示，阿托伐他汀和普伐他汀治疗分别与对照组相比，均可显著提高GFR。治疗前后GFR差值的SMD分别为1.87[95%CI（1.05，2.69），P<0.00001]和0.05[95%CI（0.02，0.08）， P=0.0009]。结论：阿托伐他汀和普伐他汀均可提高心血管疾病合并CKD1-2期患者的GFR。