他汀类药物防治阿尔茨海默病疗效及安全性的Meta分析

发布时间：2018-04-08 18:17

本文选题：他汀类药物　切入点：阿尔茨海默病(AD)　出处：《中国老年学杂志》2014年18期

【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。
[Abstract]:Objective to evaluate the efficacy and safety of statins in the prevention and treatment of Alzheimer's disease (AD).Methods the search system of PubMedus EM-BASE Cochrane Library Data and CBM was searched by computer, and the retrieval time was up to April 2012.A randomized controlled trial of statins for the prevention and treatment of AD was conducted. After literature screening, data extraction and quality evaluation, Meta analysis was carried out with Review Manager 5.1.0 software.Results the preventive study included 0 RCTs, the therapeutic study included 3 RCTs, a total of 746 patients were published in English.There was no significant difference in the incidence of adverse reactions between statins and placebo. There was no significant difference in the incidence of adverse reactions between statin and placebo.Conclusion statins have no obvious advantage in the prevention and treatment of AD, but they are a safe drug.Due to the small number and sample size of RCT in the study, the lack of quality of life, economic studies and other endpoints, these conclusions need to be verified by more high-quality randomized double-blind controlled trials.
【作者单位】：广西壮族自治区人民医院神经内科;
【分类号】：R749.16

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