摘要
目的:系统评价匹伐他汀对比阿托伐他汀治疗中国成人原发性高脂血症的疗效及安全性,为临床提供循证参考。方法:计算机检索The Cochrane Library、Pub Med、中国期刊全文数据库、万方数据库,人工检索Google Scholar、百度学术等搜索引擎,收集匹伐他汀(试验组)对比阿托伐他汀(对照组)治疗中国成人原发性高脂血症的随机对照试验(RCT),筛选文献、提取资料并采用改良Jadad量表评价纳入研究的质量后,采用Rev Man 5.3统计软件对两组患者的总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、三酰甘油(TG)和高密度脂蛋白胆固醇(HDL-C)的变化水平、有效率及不良反应发生率等指标进行Meta分析。结果:共纳入5项RCT,共456例患者。Meta分析结果显示,试验组患者TC降低水平[MD=0.09,95%CI(0.01,0.16),P=0.03]高于对照组,HDL-C升高水平[MD=0.08,95%CI(0.01,0.14),P=0.03]、TG降低水平[MD=-0.13,95%CI(-0.20,-0.06),P=0.000 4]低于对照组,差异均有统计学意义。两组患者LDL-C降低水平[MD=-0.01,95%CI(-0.13,0.10),P=0.84]、有效率[OR=0.75,95%CI(0.15,3.66),P=0.72]、不良反应发生率[OR=0.68,95%CI(0.44,1.05),P=0.08]比较,差异均无统计学意义。结论:匹伐他汀降低TC的疗效较好,降低LDL-C的疗效与阿托伐他汀相当,降低TG及升高HDL-C的疗效劣于阿托伐他汀。但两药安全性相当。
OBJECTIVE： To systematically evaluate therapeutic efficacy and safety of pitavastatin comparison of atorvastatin in the treatment of primary hyperlipemia in Chinese adults, and to provide evidence-based reference for clinic. METHODS： Retrieved from The Cochrane Library, PubMed, Chinese Journal Full-text Database, Wanfang database, and manually search Google Schol- ar, about:blank academic search engine, randomized controlled trials （RCTs） about pitavastatin （trial group） vs. atorvastatin （control group） in the treatment of primary hyperlipemia in Chinese adults were collected. After literature screening, data extraction, quality evaluation of included studies with modified Jadad scale, Meta-analysis of the levels of total cholesterol （TC）, low density lipopro- tein cholesterol （LDL-C）, triglyceride （TG） and high-density lipoprotein cholesterol （HDL-C）, response rate and the incidence of ADR was conducted by using Rev Man 5.3 statistical software. RESULTS： A total of 5 RCTs were included, involving 456 patients. Results of Meta-analysis showed that the decrease of TC level [MD=0.09, 95%CI（0.01, 0.16）,P=0.03] in trial group was more better than control group, while the increase of HDL-C level [MD=0.08, 95% CI （0.01, 0.14） , P=0.03] and the decrease of the TG level [MD=- 0.13, 95% CI （ - 0.20, -0.06）, P-0.000 4] in trial group were worse than control group, with statistical significance. There was no statistical dif- ference in the decrease of LDL-C[MD=-0.01, 95% CI （ - 0.13, 0.10）, P-0.84], response rate [OR=0.75, 95% CI （0.15, 3.66）,P=0.72] or the incidence of ADR [OR=0.68,95%CI（0.44, 1.05）,P=0.08] between 2 groups. CONCLUSIONS： Pitavastatin has better therapeutic efficacy in decreasing TC, but its therapeutic efficacy in decreasing LDL-C is similar to that of atorvastatin; its therapeutic efficacy in decreasing TG and in- creasing HDL-C is worse than that of atorvastatin. The safety of them is equivalent.
出处
《中国药房》
CAS
北大核心
2018年第1期106-111,共6页
China Pharmacy
基金
国家自然科学基金资助项目(No.81173058
81502419)
