SGLT-2抑制剂对2型糖尿病患者大血管病变危险因素影响的系统评价
发布时间：2018-09-04 14:28
【摘要】：目的系统评价SGLT-2抑制剂对2型糖尿病患者大血管病变危险因素的影响,为制定降糖方案提供一定理论依据。方法计算机检索PubMed、EMBASE、Cochrane Library、中国知网(CNKI)、万方、重庆维普(VIP)、中国生物医学文献数据库(CBM)等数据库建库截至2015年3月的有关文献。纳入以SGLT-2抑制剂与安慰剂比较对2型糖尿病(T2DM)患者大血管病变危险因素影响的随机对照试验(RCT),根据Cochrane系统评价手册5.1质量评价标准评价,采用RevMan5.2软件进行meta分析。二分类变量(计数资料)采用相对危险度RR、连续性变量(计量资料)采用标准均数差(SMD)作为效应量,各效应量都选用95%可信区间(CI)及P值表示。采用卡方检验分析各研究或各亚组研究之间的统计学异质性,当各研究或各亚组研究之间无统计学异质性(P≥0.1,I2≤50%),采用固定效应模型实施Meta分析；当各研究或各亚组研究间存在统计学异质性(P0.1,I250%),分析异质性的原因,采用亚组分析进行分析。对异质性过大或无法获得原始数据来源时,采用描述性分析。P0.05,表明有统计学意义。采用漏斗图(Funnel plot)评价发表偏倚。结果共纳入15个前瞻性随机对照试验进行分析,发表语种均为英文,包括5220例2型糖尿病患者,其中SGLT-2抑制剂组3393例,对照组1827例,试验时间最长52周,最短12周。Meta分析结果显示,①与安慰剂组相比,SGLT-2抑制剂能更有效降低糖化血红蛋白,合并效应量为[SMD=-0.94,95%CI (-1.14,-0.74), P＜0.00001],异质性检验提示各研究间存在统计学异质性(P0.00001,I2=90%),进行亚组分析提示无论病程长短、疗程长短、合并用药与否,SGLT-2抑制剂能更有效降低糖化血红蛋白。②有效减轻体重,合并效应量为[SMD=-0.72,95%CI(-0.88,-0.55),P0.00001]。③有一定降低收缩压、舒张压的效果,合并效应量分别为[SMD=-0.32,95%CI(-0.38,-0.26),P0.00001]、[SMD=-0.28,95%CI(-0.34,-0.21),P0.00001]。④有效减少甘油三酯水平[SMD=-0.17,95%CI(-0.23,-0.11),P0.00001]；增加高密度脂蛋白胆固醇[SMD=0.30,95%CI(0.21,0.38),P0.00001]；有一定增加低密度脂蛋白胆固醇水平的风险[SMD=0.17,95%CI(0.11.,0.23),P0.0.0001]。结论SGLT-2抑制剂可有效降低2型糖尿病患者的糖化血红蛋白、体重、血压、甘油三酯,增加高密度脂蛋白胆固醇,有一定增加低密度脂蛋白胆固醇水平的风险。
[Abstract]:Objective to evaluate the effect of SGLT-2 inhibitor on the risk factors of macroangiopathy in patients with type 2 diabetes mellitus and to provide a theoretical basis for developing a hypoglycemic regimen. Methods the relevant documents were searched by computer in PubMed,EMBASE,Cochrane Library, (CNKI), Wanfang, Weipu (VIP), Chongqing, China Biomedical Literature Database (CBM), and so on, until March 2015. A randomized controlled trial (RCT), in which SGLT-2 inhibitors were compared with placebo on the risk factors of macrovascular disease in type 2 diabetes mellitus (T2DM) patients, was evaluated according to the Cochrane system evaluation manual 5.1 quality evaluation criteria. Meta analysis was performed with RevMan5.2 software. The second classification variable (counting data) uses the relative risk RR, continuity variable (the measurement data) to adopt the standard mean difference (SMD) as the effect quantity, each effect quantity all uses 95% confidence interval (CI) and the P value to express. The statistical heterogeneity was analyzed by chi-square test. When there was no statistical heterogeneity among the studies or subgroups (P 鈮，
本文编号：2222430
[Abstract]:Objective to evaluate the effect of SGLT-2 inhibitor on the risk factors of macroangiopathy in patients with type 2 diabetes mellitus and to provide a theoretical basis for developing a hypoglycemic regimen. Methods the relevant documents were searched by computer in PubMed,EMBASE,Cochrane Library, (CNKI), Wanfang, Weipu (VIP), Chongqing, China Biomedical Literature Database (CBM), and so on, until March 2015. A randomized controlled trial (RCT), in which SGLT-2 inhibitors were compared with placebo on the risk factors of macrovascular disease in type 2 diabetes mellitus (T2DM) patients, was evaluated according to the Cochrane system evaluation manual 5.1 quality evaluation criteria. Meta analysis was performed with RevMan5.2 software. The second classification variable (counting data) uses the relative risk RR, continuity variable (the measurement data) to adopt the standard mean difference (SMD) as the effect quantity, each effect quantity all uses 95% confidence interval (CI) and the P value to express. The statistical heterogeneity was analyzed by chi-square test. When there was no statistical heterogeneity among the studies or subgroups (P 鈮，
本文编号：2222430
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