摘要
目的系统评价中国冠心病患者应用依折麦布联合阿托伐他汀与单独使用阿托伐他汀的疗效和安全性。方法系统检索EMBASE、PubMed、中国期刊全文数据库、中国生物医学文献数据库及万方数据库检索,搜集有关中国冠心病患者应用依折麦布联合阿托伐他汀与单独使用阿托伐他汀治疗的疗效和安全性比较的随机对照研究,采用RevMan5.3 软件进行Meta 分析。结果纳入13 项随机对照研究共1 490 例患者。Meta 分析结果显示:与单独使用阿托伐他汀组相比,联合用药组在随访期间低密度脂蛋白胆固醇(均数差=-0.67,95%可信区间-0.83--0.51,P<0.05)、总胆固醇(均数差=-0.90,95%可信区间-1.09--0.71,P<0.05)、甘油三酯(均数差=-0.21,95%可信区间-0.35--0.06,P<0.05)、不良反应发生率(肌痛比值比=0.32,95%可信区间0.13-0.79,P<0.05;胃肠道反应比值比=0.36,95%可信区间0.17-0.79,P<0.05)均显著降低,临床疗效(比值比=3.53,95%可信区间2.21~5.65,P<0.05)显著提高。结论中国冠心病患者应用依折麦布联合阿托伐他汀可显著降低患者的血脂水平和不良反应的发生率。
Objective To evaluate the efficacy and safety of Ezetimibe combined with Atorvastatin and Atorvastatin alone in patients with coronary heart disease (CHD) in China. Methods EMBASE,PubMed,CNKI,CBM and Wanfang database were used to search the data of Chinese patients with CHD who were treated with Ezetimibe and Atorvastatin alone. Randomized controlled trials (RCTs) comparing the efficacy and safety of statin treatment with Atorvastatin and meta-analysis using RevMan5.3 software. Results A total of 1 490 patients were enrolled in 13 RCTs. Meta-analysis showed that major improvement in combination group with in aspect of low-density lipoprotein cholesterol (LDL-C)(MD=-0.67,95%CI -0.83--0.51,P<0.05),total cholesterol(TC)(MD=-0.90,95%CI -1.09--0.71,P< 0.05),triglyceride(TG)(MD=-0.21,95%CI -0.35-0.06,P<0.05)and The incidence of adverse reactions(myalgia: OR=0.32,95%CI 0.13-0.79,P<0.05;the incidence of gastrointestinal reactions:OR=0.36,95%CI 0.17-0.79,P<0.05). The clinical effect(OR=3.53,95%CI 2.21-5.65,P<0.05)increased significantly. Conclusion The use of Ezetimibe and Atorvastatin in CHD patients in China can significantly reduce the incidence of adverse reactions and blood lipid levels in patients with CHD.
作者
郑丽
王一淳
赵妍
ZHENG Li;WANG Yi-chun;ZHAO Yan(Department of Pharmacy,731 Hospital of China Aerospace Science and Industry Corporation,Beijing 100074,China;Department of Pharmacy,Beijing Hospital,Beijing 100730,China)
出处
《循证医学》
2019年第3期160-166,177,共8页
The Journal of Evidence-Based Medicine
