2000-2006年他汀类药物对糖尿病肾病尿蛋白影响的国内文献Meta分析

A Meta-analysis for evaluating the effect of statins on albuminuria in the diabetes-induced renal diseases(2000-2006)

目的:评价他汀类药物对糖尿病肾病尿蛋白的影响。方法:对国内他汀类药物影响糖尿病肾病尿蛋白的对照研究进行全面调查,对15项随机对照试验(包括1 364例患者)进行Meta分析。结果:采用随机效应模型对24 h尿蛋白进行比较:2χ=22.31,加权均数差(WMD)=-0.68(-1.15,-0.21)。采用随机效应模型对早期糖尿病肾病24 h尿白蛋白进行比较:χ2=925.73,WMD=-42.94(-85.19,-0.50)。采用随机效应模型对临床期糖尿病肾病24 h尿白蛋白进行比较:χ2=63.77,WMD=-566.72(-1 597.57,-464.12);报道的不良反应比较轻微。结论:他汀类药物可以降低糖尿病肾病的病理性尿蛋白,对尿白蛋白的作用不明显,但是否对终末期肾病有效,还取决于能在多大程度上改善尿蛋白的排泄,仍然需要大量的大规模多中心随机临床对照试验来加以证明。

Objective：To evaluate the effect of statins in the diabetes-induced renal diseases. Methods： All the papers of randomized controlled trials evaluating the effects of statins on diabetes-induced renal diseases in China were investigated. Meta-analysis was performed on the basis of the evaluation of 15 trails of randomized controlled trials （including 1 364 patients）. Results： The proteinuria excretion measured by 24 h urine collection was compared by random effect model： χ^2 = 22.31 , WMD = - 0.68 （ - 1. 15, - 0.21）. The albuminuria excretion measured by 24-h urine collection in the early stage was compared by random effect model： χ^2 = 925.73, WMD = - 42.94 （ - 85.19, - 0.50）. The albuminuria excretion measured by 24 h urine collection in the clinical stage was compared by random effect model： χ^2=63.77, WMD = -566.72（ -1 597.57, -464.12） ; the reported ADRs were relatively mild. Conclusion： Statins have a beneficial effect on pathological proteinuria but not on the albuminuria in the diabetes-induced renal diseases. The validity of this finding requires supports by more studies of larger size to evaluate the effect on end-stage of the diseases.