降压药对冠心病合并高血压患者血管结构作用的Meta分析

Efficacy of Antihypertensive Agents on Vascular Structure in Patients with Coronary Heart Disease Combined with Hypertension:A Meta-analysis

目的评价降压药对冠心病合并高血压患者血管结构的作用。方法按照循证医学的要求,制定相应的文献纳入、排除标准及其检索策略。计算机检索Cochrane图书馆临床随机对照试验资料库(CCRCT)、PubMed、EMBase、万方数据库、中国学术期刊全文数据库(CNKI)、中国生物医学文献数据库(CBM)、维普中文科技期刊数据库(VIP)。纳入文献以冠心病合并高血压患者为研究对象,均使用降压药治疗,采用血管内超声(IVUS)作为检查手段,检测冠状动脉斑块体积变化。由2名评价员采用统一的资料提取表独立地评价纳入文献的质量并交叉核对,采用RevMan 5.0软件进行Meta分析。结果共纳入3篇英文文献,包括719例患者,其中使用降压药的治疗组为418例,对照组为301例。纳入的3篇文献均采用了随机对照试验和盲法,无分配隐藏;均未出现失访或提前退出试验患者。Meta分析结果显示,治疗组患者冠状动脉斑块缩小体积与对照组比较,差异无统计学意义〔WMD=-1.10,95%CI(-3.86,1.65),P>0.05〕。结论降压药对缩小冠心病合并高血压患者血管斑块的体积可能无明显作用。

Objective To evaluate the effects of antihypertensive drugs on the vascular structure in patients with coronary heart disease （CHD） combined with hypertension. Methods Based on the principles of evidence - based medicine, corresponding inclusion and exclusion criteria, search strategies were developed. This study enrolled patients with CHD combined with hypertension who had antihypertensive drug treatment and intravascular ultrasound （IVUS） to detect the volumetric changes of coronary plaques by searching CCRCT, PubMed, EMBase, Wanfang Data, Chinese Biomedical Literature Database, Chinese Scientific Journal Full - text Database, and Chinese Journal Full - text Database. Two evaluators cross - checked, using unified data extraction forms, the quality of the enrolled studies independently. RevMan 5. 0 software was used to perform Metaanalysis. Results A total of 3 English literatures were enrolled including 719 patients （418 administrated antihypertensive drugs enrolled as study group, 301 as control group）. The 3 literatures adopted randomized controlled trials and blind method without allocation concealment; no patients had loss to follow up or early termination of the trials. Meta - analysis showed that there were no significant differences in antihypertensive drugs decreasing the volume of coronary plaques between 2 groups [WMD = - 1. 10, 95% CI （ - 3. 86, 1. 65）, P 〉 0. 05 ]. Conclnsion Antihypertensive drugs decreasing volume of coronary plaques may not effect so obviously in patients with CHD combined with hypertension.