瑞舒伐他汀联合依折麦布调脂疗效Meta分析

A Meta analysis on lipid-lowering effect of rosuvastatin combining ezetimibe therapy

目的对瑞舒伐他汀联合依折麦布降脂疗效的研究进行Meta分析。方法在CNKI、PubMed检索2004~2014年国内外研究瑞舒伐他汀与依折麦布联合用药的随机对照试验,由2名作者独立阅读文献,纳入试验、提取资料并进行质量评估,用Revman 5.2软件对其数据进行分析。结果最终纳入11项研究,纳入研究对象1 248例。Meta分析结果显示:与单独口服瑞舒伐他汀相比,瑞舒伐他汀联合依折麦布显著降低血浆胆固醇(TC)水平(SMD=-22.50,95%CI:-26.46^-18.55,P<0.01)、血浆低密度脂蛋白胆固醇(LDL-C)水平(SMD=-17.93,95%CI:-20.26^-15.59,P<0.01)、血浆三酰甘油(TG)水平(SMD=-9.74,95%CI:-17.03^-2.45,P=0.009),但对于高密度脂蛋白胆固醇(HDL-C)水平变化不明显(SMD=-0.15,95%CI:-0.87^-0.56,P=0.67)。结论瑞舒伐他汀联合依折麦布在降低血浆TC、LDL-C、TG方面均优于单独应用瑞舒伐他汀,但对于HDL-C变化无明显差异。

Objective To review the lipid-lowering effect of rosuvastatin combining ezetimibe therapy by Meta analysis. Methods The databases of CNKI and PubMed database were retrieved with computers for collecting randomized controlled trials （RCT）about rosuvastatin combining ezetimibe in lipid-lowering treatment from 2004 to 2014. All literature was read and selected by two researchers independently, and materials were extracted and given methodological quality evaluation. The Meta analysis was conducted by using RevMan 5.2 software. Results There were totally 11 RCT included involving 1 248 cases. The results of Meta analysis showed that rosuvastatin combining ezetimibe therapy compared with rosuvatatin monotherapy decreased significantly the levels of plasma total cholesterol（TC, SMD=- 22.50,95%CI：- 26.46 ,-18.55, P〈0.01）, low-density lipoprotein cholesterol （LDL-C, SMD= - 17.93,95% CI： - 20.26, - 15.59, P〈0.01）, and triglyceride（TG, SMD = - 9.74,95 % CI： - 17.03, - 2.45, P=0. 009）,however, there was little difference between the baseline values and the high density lipoprotein cholesterol（ HDL-C, SMD=-0. 15,95%CI：-0. 87,-0. 56,P=0. 67）. Conclusion Meta analysis from RCT shows that rosuvastatin combining ezetimibe therapy is effective in reducing the plasma TC, LDL-C and TG, which were better than the single application of rosuvastatin of atorvastatin,but there was no significant difference in the change of high density lipoprotein cholesterol.