T型钙离子通道阻滞药治疗慢性肾病合并高血压的系统评价

T-type Calcium Channel Blockers for Chronic Kidney Disease Complicating with Hypertension:a System Review

目的:系统评价T型钙离子通道阻滞药治疗慢性肾病合并高血压的疗效。方法:计算机检索PubMed、EMbase、Central、中国期刊全文数据库(CNKI)、万方数据库及维普数据库(VIP),收集T型钙离子通道阻滞药与L型钙离子通道阻滞药治疗慢性肾病合并高血压的临床随机对照试验(RCT),采用RevMan5.1软件进行Meta分析。结果:共纳入4项RCT,合计272例患者。Meta分析结果显示,L型钙离子通道阻滞药对收缩压的控制好于T型[WMD=1.58,95%C(I1.20,1.95),P<0.00001],对舒张压的控制与T型相当[WMD=0.42,95%CI(-1.60,2.45),P=0.68];与L型钙离子通道阻滞药比较,T型可显著地提高肌酐清除率[WMD=7.79,95%CI(4.75,10.82),P<0.00001]。结论:T型钙离子通道阻滞药用于治疗慢性肾病合并高血压,能够有效降低血压,改善肾脏功能。

OBJECTIVE： To evaluate the therapeutic efficacy of T-type calcium channel blockers （CCB） for chronic kidney disease complicating with hypertension systematically. METHODS： Retrieved from PubMed, EMbase, Central, CNKI, Wanfang data- base and VIP, randomized controlled trials about T-type CCB and L-type CCB for chronic kidney disease complicating with hypertension were collected. Meta-analysis was performed for included studies using Revman 5.1 software. RESULTS： 4 RCTs were included, involving 272 subjects. Results of Meta-analysis indicated L-type CCB was better than T-type CCB in control of systolic pressure, compared with L-type CCB [WMD=l.58, 95%CI（1.20, 1.95）, P〈0.000 01], similar to T-type CCB in control of dia- stolic pressure [WMD = 0.42, 95 % CI （- 1.60, 2.45）, P= 0.68] ; T-type CCB performed an improvement of creatinine clearance rate, compared with L-type CCB[WMD=7.79, 95% CI（4.75 , 10.82）, P〈0.000 01]. CONCLUSION： T-type CCB is benefit to chronic kidney disease patients with hypertension. It can reduce blood pressure effectively and improve renal function.