瑞舒伐他汀对早期糖尿病肾病作用的meta分析

Efficacy of rosuvastatin for early diabetic nephropathy: A meta-analysis

关键词:  糖尿病肾病  瑞舒伐他汀  meta分析

Key words:  diabetic nephropathy  rosuvastatin  meta-analysis

摘要:

目的评价瑞舒伐他汀对早期糖尿病肾病(diabetic nephropathy, DN)时尿白蛋白排泄的影响。方法计算机检索Cochrane图书馆、PubMed、EMbase、万方、中国知网数据库,手工检索相关文献,按纳入与排除标准选择随机对照试验(randomized controlled trial, RCT)。评价质量及提取资料后,采用RevMan 5.3软件对数据进行meta分析。结果最终纳入11篇文献共11个RCT,包括881例患者。纳入文献总体质量不高,均为C级。meta分析结果显示,试验组C反应蛋白(CRP)(WMD=-2.41,95% CI: -4.50～-0.32,P＜0.01)和尿白蛋白排泄率(urinary albumin excretion rate, UAER)(SMD=-1.32,95%CI: -1.75～-0.88,P＜0.01)较对照组均明显降低,血肌酐(Scr)(SMD=-0.33,95%CI: -0.70~0.04,P＞0.05)较对照组无明显变化。纳入的文章均未报到严重不良反应事件。结论 瑞舒伐他汀能降低早期DN患者UAER及CRP,对肾脏有保护作用,无严重不良反应。

Abstract:

Objective To assess the efficacy of rosuvastatin for early diabetic nephropathy(DN). Methods Clinical trials of rosuvastatin in treatment of early diabetic nephropathy were searched in the Cochrane Central Register of Controlled Trials, PubMed, EMbase, Wanfang and CNKI. We also searched relevant journals and conference proceedings. Randomized controlled trials(RCTs) in which rosuvastatin were used for patients with early DN were collected. We performed meta-analysis with RevMan 5.3 software. ResultsA total of 11 articles involving 881 patients were finally included. The evidence provided by these articles were regarded as grade C. Meta-analysis showed that CRP(WMD=-2.41,95%CI: -4.50--0.32,P＜0.01) and urinary albumin excretion rate(UAER)(SMD=-1.32,95%CI: -1.75--0.88,P＜0.01) in rosuvastatin group were lower than those in control group,but there were no significant difference in serum creatinine(Scr)(SMD=-0.33,95%CI: -0.70-0.04,P＞0.05) between rosuvastatin group and control group. No severe adverse effects were found in these trials. Conclusion Our study showed that rosuvastatin may reduce CRP and UAER levels in patients with early DN. However, due to lack of high quality articles, more studies should be conducted to reveal the efficacy of rosuvastatin for early DN.