吲达帕胺联用血管紧张素转化酶抑制剂与血管紧张素转化酶抑制剂单用对比治疗高血压的系统评价

Indapamide-ACEI combination versus ACEI therapy for hypertension:a systematic review

目的:系统的评价吲达帕胺联用血管紧张素转化酶抑制剂(ACEI)对比血管紧张素转化酶抑制剂治疗高血压的疗效和安全性。方法:计算机检索Cochrane图书馆、PubMed、Embase、SCI、CBM、CNKI、维普、万方数据库,纳入吲达帕胺血管联用ACEI对比血管紧张素转化酶抑制剂治疗高血压的随机对照试验(RCT),对纳入研究进行方法学质量评价,并用RevMan 5.0进行Meta分析。结果:共纳入46个RCTs。Meta分析结果显示2组总有效率、显效率、收缩压降低值、舒张压降低值、药物不良反应发生率差异均有统计学意义[RR=1.51,95%CI(1.35,1.69),P<0.000 01;RR=1.51,95%CI(1.35,1.69),P<0.000 01;MD=10.47,95%CI(8.61,12.34),P<0.000 01;MD=6.19,95%CI(4.62,7.76),P<0.000 01;RR=0.58,95%CI(0.44,0.77),P=0.000 2]。结论:基于当前临床证据,吲达帕胺联用血管紧张素转化酶抑制剂治疗高血压的疗效和安全性均好于血管紧张素转化酶抑制剂单用。

OBJECTIVE To assess the effectiveness and safety of indapamide-ACEI combination versus ACEI therapy for hypertension.METHODS Randomized controlled trails（RCT） of indapamide-ACEI combination versus ACEI therapy for hypertension were gathered from the Cochrane Library,PubMed,Embase,SCI,CBM,CNKI,VIP,Wangfang Database,each RCT was methodological quality evaluated,then analyzed by software RevMan5.0.RESULTS A total of 46 RCTs were collected;according to the Meta-analysis： the difference of total effective rate,effective rate,ΔSBP,ΔDBP,ADR rate was significant[RR=1.51 , 95%CI（1.35, 1.69） , P〈0. 000 01 ; RR = 1.51, 95%CI（1.35,1.69） , P〈0. 000 01 ; MD = 10.47, 95%CI（8.61, 12.34）,P〈0. 000 01;MD= 6. 19, 95%CI（4. 62,7.76）,P〈0. 000 01;RR=0.58,95%CI（0.44,0.77）,P= 0. 000 2] CON-CONCLUSION According to the evidence currently,the effectiveness and safety was better in the indapamide-ACEI combination group.