他汀预防心脏介入手术患者造影剂肾病的Meta分析

Efficacy of Statins for Contrast Induced Nephropathy(CIN) Prevention in Cardiac Intervention Surgery Patients: A Meta-analysis

目的系统评价他汀类药物预防心脏介入手术患者造影剂肾病(CIN)的有效性。方法计算机检索PubMed、Web of Knowledge、The Cochrane Library(2015年第5期)、VIP、WanFang Data和CNKI数据库,搜集他汀类药物预防心脏介入手术患者CIN的相关随机对照试验(RCT),检索时限均从建库至2015年5月。由2位评价员独立筛选文献、提取资料,并评价纳入研究的偏倚风险后,采用RevMan 5.2软件进行Meta分析。结果共纳入25个RCT,37 353例受试者,最终发生CIN 3 794例。Meta分析结果显示:他汀组的CIN的发生率明显低于安慰剂/空白对照组,且差异有统计学意义[OR=0.52,95%CI(0.42,0.66),P<0.000 01]。结论现有证据表明,他汀类药物能预防心脏介入手术患者的造影剂肾病。但受纳入研究的质量限制。

Objective To systematically review the efficacy of statins for contrast induced nephropathy （CIN） prevention in cardiac intervention surgery patients. Methods We electronically searched databases including PubMed, Web of Knowledge, The Cochrane Library （Issue 5, 2015）, VIP, WanFang Data and CNKI to collect randomized controlled trials （RCTs） about statins for CIN prevention in cardiac intervention surgery patients from inception to May 2015. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.2 software. Results A total of 25 RCTs involving 37 353 patients were included, among them, 3 794 were CIN patients. The results of meta-analysis indicated that： compared with the placebo/blank group, the incidence rate of CIN was decreased in the statins group with a significant difference （OR=0.68, 95%CI 0.63 to 0.73, P〈0.000 01）. Conclusion Current evidence shows statins can reduce incidence of CIN in cardiac intervention surgery patients. Due to limited quality and quantity of the included studies, the above conclusions need more high quality studies to verify.