阿托伐他汀对糖尿病肾病患者肾脏保护作用的Meta分析

Protective Effect of Atrovastatin on Renal Tissue in Patients with Diabetic Nephropathy:A Meta-analysis

目的:系统评价阿托伐他汀对糖尿病肾病患者的肾脏保护作用,以为临床治疗提供循证参考。方法:计算机检索PubMed、EMBase、Medline、The Cochrane Library、中国生物医学文献数据库、中国期刊全文数据库、中文科技期刊全文数据库、万方数据库中有关阿托伐他汀对糖尿病肾病患者肾脏保护作用的随机对照试验(RCT),按纳入与排除标准选择文献并进行资料提取和质量评价后,采用Rev Man 5.2统计软件进行Meta分析。结果:共纳入9项RCT,合计722例患者。Meta分析结果表明,在常规治疗基础上加用阿托伐他汀可有效地降低糖尿病肾病患者尿白蛋白排泄率[MD=-35.31,95%CI(-65.92,-4.69),P=0.02]、血肌酐水平[MD=-7.63,95%CI(-14.10,-1.15),P=0.02],但对患者血尿素氮水平改善不明显[MD=-0.09,95%CI(-0.80,0.63),P=0.82]。结论:在常规治疗基础上加用阿托伐他汀对糖尿病肾病患者肾脏有保护作用,能够明显改善患者尿白蛋白排泄率、血肌酐等相关指标。由于纳入研究的质量不高,该结论还有待更多高质量、大样本的RCT加以验证。

OBJECTIVE： To evaluate the effectiveness and safety of protective effect of atrovastatin on renal tissue in patients with diabetic nephropathy （DN）, and to provide evidence-based reference for clinical use. METHODS： Retrieved from PubMed, EMBase, Medline, Cochrane Library, CNKI, Wanfang database, VIP and CBM, RCT about protective effect of atrovastatin on re- nal tissue of DN patients were included, and these included RCT were analyzed in quality by evidence-based medicine literature analysis after data extraction. Meta-analysis was performed by using Rev Man 5.2 software. RESULTS ： A total of 9 RCT were in- cluded, involving 722 patients. Meta-analysis showed that atrovastatin could decrease the level of UAER [MD=- 35.31,95%CI （ -65.92, -4.69） ,P=0.02], Scr [MD= -7.63,95%CI（ -14.10, - 1.15） ,P=0.02] except for BUN [MD= -0.09,95%CI（ -0.80, 0.63） ,P=-0,82]. CONCLUSIONS： Atrovastatin for DN can significantly improve UAER, Scr, BUN and other index. Due to low quality of included studies, more high quality and large-scale RCT are required for further study.