贝前列素钠治疗肺动脉高压的meta分析

Beraprost sodium for pulmonary arterial hypertension:A meta-analysis

目的:系统评价贝前列素钠治疗肺动脉高压(PAH)的有效性及安全性。方法:计算机检索Pub Med、EMbase、Cochrane Library、CNKI、CBM和VIP收集贝前列素钠治疗PAH的随机对照试验,检索时间截至2015年1月3日。由2名研究者按照纳入排除标准独立筛选文献、提取资料并评价纳入试验的偏倚风险,用Rev Man 5.3软件进行Meta分析。结果:共纳入7项随机对照试验(490例患者),试验的偏倚风险为"高偏倚"或"不清楚"。Meta分析结果显示:贝前列素钠可显著提高6分钟步行距离,显著降低平均肺动脉压、肺动脉收缩压和脑钠尿肽水平,但会增加某些不良反应的发生率。此外,贝前列素钠与西地那非在改善PAH症状方面(除平均肺动脉压外)差异无统计学意义。结论:贝前列素钠可有效治疗PAH,但相对增加一些不良反应,需高质量试验进行验证。

Objective： To systematic review the effectiveness and safety of beraprost sodium for treating pulmonary arterial hypertension（PAH）. Methods： Electronic databases including Pub Med, EMbase, The Cochrane Library, CNKI, CBM and VIP were searched from the date of their establishment to January 3, 2015 to collect the randomized controlled trials（RCTs） of beraprost sodium for treating PAH. Two researchers independently selected the citations according to the inclusive inclusion and exclusive exclusion criteria, extracted the data and assessed the risk of bias of the included studies. Meta-analysis was carried out by using Rev Man 5.3 software. Results： A total of 7 RCTs involving 490 patients were included. The risk of bias of the included RCTs were ＂high＂ or ＂unclear＂. The results of Metameta-analysis showed that beraprost sodium can significantly increase the 6MWD, reduce m PAP、BNP and s PAP, but significantly increase the incidence of some adverse reactions. In additional, there was no significant difference between beraprost sodium and sildenafil in the outcomes of PAH symptom improvement but m PAP. Conclusion： Beraprostis sodium can is effective in the treatment of PAH, but increasing increases the incidence of some adverse reactions. More high quality trials are needed to confirm the results.