美托洛尔及阿替洛尔治疗高血压有效性及安全性的系统评价

Effectiveness and safety of metoprolol and atenolol on treating hypertension:a systematic review

目的系统评价美托洛尔及阿替洛尔治疗高血压的有效性及安全性。方法计算机检索自建库至2015年8月Cochrane图书馆临床对照试验资料库(CCRCT)、Embase、Pub Med、中国学术期刊全文数据库(CNKI)、中国生物医学文献数据库(CBMdisc)、万方数据库、维普数据库VIP),收集美托洛尔及阿替洛尔降血压的对比试验,按纳入和排除标准共纳入8项研究,共543例患者,使用Rev Man5.0软件进行Meta分析。结果美托洛尔组降低收缩压的疗效优于阿替洛尔组(WMD=-1.30,95%CI:-2.11^-0.48,P=0.002);美托洛尔组降低舒张压的疗效优于阿替洛尔组(WMD=-0.75,95%CI:-1.32^-0.18,P=0.010);而两组实验对降低心率的差异无明显统计学意义(WMD=-0.28,95%CI:-0.97~0.41,P=0.43)。结论美托洛尔的总体降压疗效优于阿替洛尔,降低心率方面差异无统计学意义。

Objective To assess the antihypertensive efficacy and safety of metoprolol and atenolol on treating hypertension. Methods The databases of CCRCT, Embase, PubMed, CNKI, CBM, WanFang Database and VIP Database were retrieved with computers for gathering randomized controlled trials （ RCT） about the antihypertensive effects of metoprolol and atenolol from the database established to August 2015. All datas were processed and given a Meta-analysis by using RevMan 5.0 software. Results The effect of metoprolol on lowering systolic pressure was superior to atenolol（ WMD = - 1.30,95% CI： - 2.11 - - 0. 48 = 0 . 0 0 2 ） ; and the effects of atenolol on lowering diastolic pres-sure was superior to metoprolol（ WMD = -0. 75 ,95% CI： - 1. 32 - - 0 . 18 = 0 . 0 1 0 ） . There was no obvious difference between the two groups in heart rate （WMD = -0.28,95%CI： - 0. 97- - 0 . 4 1 = 0 . 4 3 ） . Conclusion Theantihypertensive efficacy of metoprolol was better than atenolol and had no obvious difference in the reduction of heart rate.