他汀类药物治疗对延缓慢性肾脏病进展的荟萃分析（英文）

发布时间：2018-06-05 21:19

本文选题：他汀类药物 + 慢性肾脏病　；参考：《南方医科大学学报》2016年04期

【摘要】：目的评价他汀类药物治疗对非透析的慢性肾脏病患者肾脏病进展的影响。方法通过对电子数据库(时间截止2015年2月)的检索,筛选符合纳入标准的随机对照试验,采用随机效应模型合并相关肾脏病进展指标。结果共纳入28个研究,共包括45 688例慢性肾脏病患者。Meta分析结果显示,与对照组相比,非透析的慢性肾脏病患者接受他汀类药物治疗不能减少终末期肾病的发生(RR=0.98,95%CI:0.91-1.05),也不能降低肌酐翻倍风险(RR 1.43,95%CI 0.26 to 7.79),但是可以降低肾小球滤过率下降≥25%的风险(RR=0.91,95%CI:0.83=0.99以及延缓肾小球滤过率下降(SMD=0.04,95%CI:0.02-0.07)。亚组分析显示,在中度慢性肾脏病患者中,他汀类药物治疗对治疗前后肾小球滤过率变化这一指标有疗效(SMD=0.09,95%CI:0.04=0.13)。阿托伐他汀(SMD=0.10,95%CI:0.03-0.17)及高强度降脂治疗(SMD=0.12,95%CI:0.02-0.21)对治疗前后肾小球滤过率变化这一指标有效。结论尽管他汀类药物对降低终末期肾病发及肌酐翻倍的发生率无明显效果,但可以延缓肾小球滤过率下降,其疗效与肾脏病分期、药物种类及降脂强度有关。
[Abstract]:Objective to evaluate the effect of statins on the progression of renal disease in non-dialysis patients with chronic kidney disease. Methods by searching the electronic database (as of February, 2015), a randomized controlled trial was selected, and a random effect model was used to combine the related progress indexes of kidney disease. Results A total of 28 studies, including 45,688 patients with chronic kidney disease, were included. Meta-analysis showed that compared with the control group, Treatment with statins in non-dialysis patients with chronic kidney disease does not reduce the incidence of end-stage nephropathy. RRN 0.9895 CI0.91-1.05A, nor does it reduce the risk of creatinine doubling: RR 1.43n 95CI 0.26 to 7.790.But it can reduce the risk of glomerular filtration rate falling by more than 25% in RR0.9195CI0.830.99 to reduce the risk of creatinine doubling (RR 1.4395 CI 0.26 to 7.79%), but it can reduce the risk of glomerular filtration rate decreasing by more than 25% (RR0.9195CI0.830.99). And delaying the decrease of glomerular filtration rate. Subgroup analysis showed that in patients with moderate chronic kidney disease, statins were effective on the change of glomerular filtration rate before and after treatment. Atto vastatin 0.1095 CI: 0.03-0.17) and high-intensity lipid lowering therapy SMD0.1295CIW 0.02-0.21) were effective on the change of glomerular filtration rate before and after treatment. Conclusion although statins have no significant effect on decreasing the incidence of hair and creatinine doubling in end-stage nephropathy, they can delay the decrease of glomerular filtration rate. The curative effect is related to the stage of kidney disease, the type of drugs and the intensity of lipid lowering.
【作者单位】：南方医科大学珠江医院肾内科;南方医科大学珠江医院急诊科;
【基金】：Supported by National Natural Science Foundation of China(81170682)~~
【分类号】：R692

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