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他汀类药物防治阿尔茨海默病疗效及安全性的Meta分析 被引量:3

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摘要 目的系统评价他汀类药物防治阿尔茨海默病(AD)的疗效及安全性。方法计算机检索PubMed、EM-BASE、Cochrane Library、CNKI、WANFANG Data和CBM检索系统,检索时间截止2012年4月。纳入有关他汀类药物防治AD的随机对照试验(RCT),进行文献筛选、资料提取和质量评价后,采用Review Manager 5.1.0软件进行Meta分析。结果预防性研究纳入0个RCT;治疗性研究纳入3个RCT,共计746例患者,均以英文发表,均为高质量研究。Meta分析结果显示:他汀类药物在阿尔茨海默病评价量表——认知部分(ADAS-Cog),简易智能精神状态量表(MMSE)评分方面的疗效与安慰剂相当,其差异无统计学意义〔MD=1.09,95%CI(-1.77,-3.94),P=0.46;MD=1.09,95%CI(-0.17,2.35),P=0.09〕。亚组分析结果显示:辛伐他汀在改善MMSE评分上疗效优于安慰剂〔MD=2.10,95%CI(0.16,4.04),P=0.03〕,阿托伐他汀能在一定程度上改善携带APE4 AD患者的ADAS-Cog评分〔MD=-3.66,95%CI(-6.15,-1.17),P=0.004〕。他汀类药物与安慰剂不良反应发生率差异无统计学意义〔RR=3.31,95%CI(1.07,10.26),P=0.04〕。结论在防治AD的疗效方面,他汀类药物未能显示出明显的优势,但是一种较为安全的药物。由于纳入研究的RCT数量及样本量较小,缺乏生活质量、经济学研究等终点指标,上述结论尚需更多高质量随机双盲对照试验加以验证。
出处 《中国老年学杂志》 CAS CSCD 北大核心 2014年第18期5059-5062,共4页 Chinese Journal of Gerontology
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