氨氯地平和硝苯地平治疗高血压有效性与安全性比较的Meta分析

Efficacy and safety of amlodipine and nifedipine in the treatment of hypertension:Meta-analysis

目的:系统评价氨氯地平和硝苯地平分别治疗高血压的有效性与安全性,为临床用药提供依据。方法:利用计算机检索Cochrane library、MEDLINE、EMBASE、Pub Med、CNKI、维普和万方数据库等信息资源系统,检索时限均从建库至2017年,采用Review Manager 5.2软件对检索到的文献进行Meta分析。结果:根据纳入、排除标准,最终筛选纳入20项国内外RCT,合计1881例患者符合纳入标准。荟萃分析(Meta分析)结果显示:氨氯地平总有效率高于硝苯地平总有效率,差异具有统计学意义[OR=2.52,95%CI(1.95,3.27),P<0.00001];氨氯地平的不良事件发生率小于硝苯地平,差异具有统计学意义[OR=0.39,95%CI(0.30,0.50),P<0.00001]。结论:氨氯地平治疗高血压的有效性与安全性高于硝苯地平。

Objective： Systematic evaluation of the efficacy and safety of amlodipine and nifedipine in the treatment of hypertension, respectively, to provide the basis for clinical drug use. Methods： Databases including Cochrane library, MEDLINE, EMBASE, PubMed, CNKI, Wan fang Database and VIP Information Resource System were electronically searched from the establishment dates to 2017. Using Review Manager 5.2 statistical program to analyze the data. Results： There were 1881 patients included in the 20 RCTs. We found that the amlodipine had a stronger effect in lowering blood pressure as compared with the nifedipine monotherapy. There was statistically significant difference [OR=2.52, 95%CI （1.95, 3.27）, P〈0.00001]; adverse drug reaction of incidence of amlodipine is less than that of nifedipine, and there was significant difference of the safety between them [ OR=O. 39, 95 % CI （0.30,0.50）, P〈0.00001 ]. Conclusion： Amlodipine provides more effective and is safer than nifedipine in the treatment of hypertension.