摘要
为了评价阿托伐他汀治疗不稳定型心绞痛(unstableangina,UA)的有效性和安全性,通过计算机检索Pubmed、Cochrane Library、EMBASE、CNKI、VIP、CBM和万方数据库,全面收集有关阿托伐他汀治疗UA的随机和半随机对照试验,按照Cochrane Library Handbook推荐的质量评价方法评价纳入研究的质量,并对符合纳入标准的研究用RevMan5.0软件对数据进行Meta分析。共纳入38篇文献,包括3 373例UA患者。Meta分析结果显示:与常规治疗组相比,阿托伐他汀治疗组可提高治疗UA的总体有效率,改善UA患者总胆固醇(TC)、血浆甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C),减少心血管事件发生率,降低高敏C反应蛋白(CRP),减少UA患者心绞痛发作次数,改善不稳定型心绞痛的心电图变化,且阿托伐他汀剂量为10、20和40 mg.d-1以及治疗时间为≤1月和>1月时没有明显的疗效差别。但对缩短心绞痛持续时间的效果不明显。所有纳入研究未出现严重的不良反应。现有研究表明,阿托伐他汀在剂量为10 mg.d-1,疗程为一个月时治疗UA有一定有效性和安全性。但纳入研究质量偏低且存在发表偏移,论证强度不够,尚需开展设计严格的高质量随机双盲对照试验,进一步验证阿托伐他汀治疗UA患者的有效性和安全性。
To assess the efficacy and safety of atorvastatin in treatment with unstable angina（UA）.The online database including PubMed,the Cochrane Library,EMBASE,CNKI,VIP, CBM and Wanfang were searched and the studies of randomized and controlled trials of atorvastatin in the treatment of UA were collected.The quality of the included documents was evaluated by the criterion that Cochrane Library Handbook recommended. The Cochrane Collaboration＇s RevMan 5.0 software was used for data analyses.A total of 38 studies involving 3373 participants were included.Meta-analyses showed that compared with conventional treatment group,atorvastatin group could significantly improve the unstable angina＇s overall efficiency,lower the total cholesterol（TC）,triglycerides（TG）,low-density lipoprotein cholesterol（LDL-C）,high-density lipoprotein cholesterol（HDLC）,C-reactive protein（CRP）and reduce the incidence of cardiovascular events.Atorvastatin group could also significantly reduce the UA＇s incidence of angina attacks,improve the changes of electrocardiogram and the curative effects of both groups have no obvious difference in different dosage and treatment term.But the effect of shortening the duration of angina was not obvious. Serious adverse reactions were not reported in all 38 studies.The studies show that the treatment of unstable angina with 10mg / d atorvastatin for 1 month is effect and safe.However,for the low quality of included studies and the lack of strong demonstration, high-quality strict randomized double-blind controlled trials should be carried out to verify the efficacy and safety of the treatment of atorvastatin for unstable angina.
出处
《中国药理学通报》
CAS
CSCD
北大核心
2012年第11期1500-1507,共8页
Chinese Pharmacological Bulletin
基金
甘肃省自然科学研究基金计划(No 0916RJZA007)
