瑞舒伐他汀与辛伐他汀治疗高脂血症有效性的Meta分析

Meta-analysis for efficacy and safety of rosuvastatin and simvastatin in the treatment of hyperlipidemia

目的评价瑞舒伐他汀与辛伐他汀治疗高脂血症的有效性和安全性。方法计算机检索中国知网数据库(CNKI)、维普全文数据库(VIP)、万方数据库、中国生物医学文献数据库(CBM)等数据库中发表的关于瑞舒伐他汀与辛伐他汀治疗高脂血症的临床随机对照研究,由2名评价员独立对纳入的文献进行质量评价和数据提取,采用Revman5.2软件进行Meta分析。结果本研究共纳入18项随机对照试验,共1 819例高脂血症患者,其中瑞舒伐他汀组917例,辛伐他汀组902例。Meta分析结果显示,与辛伐他汀组比较,瑞舒伐他汀组降低高脂血症患者血清总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、三酰甘油(TG)和升高高密度脂蛋白胆固醇(HDL-C)的效果更好,差异均有统计学意义(MD=-0.15,95%CI:-0.22^-0.09,P<0.01;MD=-0.18,95%CI:-0.25^-0.11,P<0.01;MD=-0.23,95%CI:-0.28^-0.19,P<0.01;MD=-0.11,95%CI:-0.06^-0.15,P<0.01)。2组胃肠不良反应的发生率差异无统计学意义。结论瑞舒伐他汀治疗高脂血症的整体疗效优于辛伐他汀,且无明显的不良反应,安全性较高。

Objective To investigate the effectiveness and safety of rosuvastatin and simvastatin in the treatment of hyperlipidemia. Methods The database including CNKI, VIP, Wanfang data base and CBM were retrieved to search the clinical randomized controlled trials （RCT） of rosuvastatin and simvastatin in the treatment of hyperlipidemia, and the data were analyzed with Review Manager 5.2. Results Eighteen RCTs were included with a total sample size of 1 819 cases with hyperlipidemia, in which there were 917 patients in rosuvastatin group and 902 in simvastatin group. The Meta-analysis results showed that there were significantly lower serum levels of total cholesterol （TC）, low-density lipoprotein cholesterol （LDL-C）, triglyceride （TG） and significantly higher level of high-density lipoprotein cholesterol （HDL-C） in rosuvastatin group compared with those of simvastatin group [（MD=-0.15, 95%CI： -0.22- -0.09, P〈0.01）, （MD=-0.18, 95%CI： -0.25- -0.11, P〈0.01）, （MD=-0.23, 95%CI： -0.28- -0.19, P〈0.01） and （MD=-0.11, 95%CI： -0.06- -0.15, P〈0.01）]. There was no significant difference in the incidence of gastrointestinal adverse reaction between the two groups. Conclusion The current clinical evidences show that rosuvastatin has a better effect on the treatment of hyperlipidemia, and has no adverse reactions.