强化降压治疗对主要心脑血管事件影响的Meta分析

发布时间：2018-03-04 16:10

本文选题：强化降压　切入点：标准降压　出处：《兰州大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:在Meta分析的帮助下,综合评估强化降压治疗至血压130/80mmHg对血压正常高值或轻度增高,同时无严重心、脑、肾脏疾病患者主要心脑血管事件的影响。方法:运用计算机检索EMBASE、MEDLINE、Cochrane Library,Web of Science和中国生物医学文献数据库等数据库,各数据库检索的时间设定为数据库建库时间至2016年9月10日,研究类型均为随机对照实验(RCT)。同时对已经注册在ClinicalTrials.gov且已经完成的但研究结果尚未发表的RCT进行检索。并对既往相关系统评价及Meta分析文章参考文献进行检索补充。然后通过拟定的标准对文献进行筛选和数据提取,并使用Cochrane风险评估工具进行研究质量评估。数据的统计分析利用RevMan 5.1统计软件。结果:本研究最终纳入RCT 10项,其中包含了57474例患者。综合分析的结果提示:由于强化降压治疗的影响,患者主要心脑血管事件风险较标准降压治疗组降低了16%(RR,0.84,95%可信区间[confidence interval,CI],0.79 0.88,P0.001)。其中脑卒中(RR,0.79;95%CI,0.71 0.89;P0.001)和心力衰竭(RR,0.75;95%CI,0.66 0.85;P0.001)风险明显降低。心源性死亡(RR,0.89;95%CI,0.80 0.98;P=0.02)和心肌梗死(RR,0.86;95%CI,0.79 0.93;P=0.0005)风险也有一定程度降低。结论:对于血压正常高值或轻度增高,同时无严重心、脑、肾脏疾病患者,强化降压至130/80mm Hg相对于标准降压至130-139/80-89mmHg明显降低主要心脑血管事件风险。
[Abstract]:Objective: to evaluate the effect of intensive hypotension therapy on blood pressure of 130 / 80mmHg with the help of Meta analysis. Methods: EMBASE MEDLINE Cochrane Library of Science and Chinese Biomedical Literature Database were searched by computer. The types of research were all randomized controlled trials. The RCT that had been registered in ClinicalTrials.gov and had been completed, but the results of the study had not been published, were also searched. The relevant system evaluation and the reference literature of Meta analysis were added to the search. ... And then sift through the developed criteria and extract the data, The Cochrane risk assessment tool was used to evaluate the quality of the research. The statistical analysis of the data was carried out using RevMan 5.1 statistical software. Results: 10 items of RCT were included in this study. It included 57474 patients. The results of the comprehensive analysis suggested that, because of the effect of intensive hypotension therapy, The risk of major cardiovascular and cerebrovascular events in the patients was significantly lower than that in the standard hypotensive treatment group. The risk of RRR 0.7595 CI 0.7595 CI 0.66 0.85 P0.001) was significantly lower than that of the standard hypotensive treatment group. The risk of cardiogenic death RRR 0.8995 CI 0.80 0.98P0.02) and myocardial infarction RRR0.8695CI0.79 P0.02) was also significantly lower than that of the standard hypotensive treatment group. The risk of cardiogenic death RRR 0.89 95 CI 0.98 P0.02 and myocardial infarction RRN 0.8695 CI0.79 0. 93P0. 05) were also significantly lower than those of the standard hypotensive treatment group. The risk of cardiogenic death RRRR 0.89 95 CI 0.98 P0. 02) and myocardial infarction RRN 0. 8695 CII 0.79 0. 93P0. 001) were also significantly lower than those of the standard hypotension treatment group. Conclusion: in the case of normal high blood pressure or slight increase in blood pressure, At the same time, no severe heart, brain and kidney disease patients, enhanced hypotension to 130 / 80 mm Hg compared with the standard hypotension to 130-139% 80-89 mmHg significantly reduced the risk of major cardiovascular and cerebrovascular events.
【学位授予单位】：兰州大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R544.1

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