天津医药 ›› 2017, Vol. 45 ›› Issue (12): 1324-1329.doi: 10.11958/20170615

• 循证医学 • 上一篇    下一篇

瑞舒伐他汀与辛伐他汀治疗高脂血症有效性的 Meta 分析

刘少云△, 杨雪佳, 孔立茶, 王东颖, 董秋立, 王忠明, 王滨, 崔松, 苗军, 田涛   

  1. 作者单位: 华北石油管理局总医院心内科 (邮编 062552) 作者简介: 刘少云 (1979), 男, 硕士, 主治医师, 主要从事心内科的研究 △通讯作者 E-mail: liushaoyun@163.com
  • 收稿日期:2017-06-01 修回日期:2017-09-30 出版日期:2017-12-15 发布日期:2017-12-15
  • 通讯作者: 刘少云 E-mail:liushaoyun1603@163.com

Meta-analysis for efficacy and safety of rosuvastatin and simvastatin in the treatment of hyperlipidemia

LIU Shao-yun△, YANG Xue-jia, KONG Li-cha, WANG Dong-ying, DONG Qiu-li, WANG Zhong-ming, WANG Bin, CUI Song, MIAO Jun, TIAN Tao   

  1. Department of Cardiology, General Hospital of North China Petroleum Administration Bureau, Hebei 062552, China △Corresponding Author E-mail: liushaoyun@163.com
  • Received:2017-06-01 Revised:2017-09-30 Published:2017-12-15 Online:2017-12-15

摘要: 目的 评价瑞舒伐他汀与辛伐他汀治疗高脂血症的有效性和安全性。方法 计算机检索中国知网数据 库 (CNKI)、 维普全文数据库 (VIP)、 万方数据库、 中国生物医学文献数据库 (CBM) 等数据库中发表的关于瑞舒伐他汀 与辛伐他汀治疗高脂血症的临床随机对照研究, 由 2 名评价员独立对纳入的文献进行质量评价和数据提取, 采用 Revman5.2 软件进行 Meta 分析。结果 本研究共纳入 18 项随机对照试验, 共 1 819 例高脂血症患者, 其中瑞舒伐他 汀组 917 例, 辛伐他汀组 902 例。Meta 分析结果显示, 与辛伐他汀组比较, 瑞舒伐他汀组降低高脂血症患者血清总 胆固醇 (TC)、 低密度脂蛋白胆固醇 (LDL-C)、 三酰甘油 (TG) 和升高高密度脂蛋白胆固醇 (HDL-C) 的效果更好, 差异 均有统计学意义(MD=-0.15, 95%CI: -0.22~-0.09, P<0.01; MD=-0.18, 95%CI: -0.25~-0.11, P<0.01; MD=-0.23, 95%CI: -0.28~-0.19, P<0.01; MD=-0.11, 95%CI: -0.06~-0.15, P<0.01)。2 组胃肠不良反应的发生率差异无统计学 意义。结论 瑞舒伐他汀治疗高脂血症的整体疗效优于辛伐他汀, 且无明显的不良反应, 安全性较高。

关键词: 高脂血症, Meta 分析, 瑞舒伐他汀, 辛伐他汀, 系统评价

Abstract: Objective To investigate the effectiveness and safety of rosuvastatin and simvastatin in the treatment of hyperlipidemia. Methods The database including CNKI, VIP, Wanfang data base and CBM were retrieved to search the clinical randomized controlled trials (RCT) of rosuvastatin and simvastatin in the treatment of hyperlipidemia, and the data were analyzed with Review Manager 5.2. Results Eighteen RCTs were included with a total sample size of 1 819 cases with hyperlipidemia, in which there were 917 patients in rosuvastatin group and 902 in simvastatin group. The Meta-analysis results showed that there were significantly lower serum levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), triglyceride (TG) and significantly higher level of high-density lipoprotein cholesterol (HDL-C) in rosuvastatin group compared with those of simvastatin group [(MD=-0.15, 95%CI: -0.22- -0.09, P<0.01), (MD=-0.18, 95%CI: -0.25- -0.11, P<0.01), (MD=-0.23, 95%CI: -0.28- -0.19, P<0.01) and (MD=-0.11, 95%CI: -0.06- -0.15, P<0.01)]. There was no significant difference in the incidence of gastrointestinal adverse reaction between the two groups. Conclusion The current clinical evidences show that rosuvastatin has a better effect on the treatment of hyperlipidemia, and has no adverse reactions.

Key words: hyperlipidemias, Meta-analysis, Rosuvastatin, Simvastatin, systemic review