西尼地平与L-型钙离子通道阻滞剂对高血压患者尿白蛋白及心率影响的Meta分析

Effects of cilnidipine and L-type calcium channel blockers on urinary albumin and heart rate in hypertensive patients:a Meta-analysis

目的:评价西尼地平与L-型钙通道阻滞剂(L-CCB)对高血压患者尿白蛋白及心率作用影响的差异。方法:检索Pub Med,Embase,Science Direct,Ebsco,Springer,Cochrane Library,Medline,万方数据库,收集从建库至2017年9月收录的有关西尼地平和L-CCB对尿白蛋白及心率影响的随机临床对照试验(RCT)。依据Jadad质量标准对纳入文献进行质量评价,采用Rev Man 5.3软件进行Meta分析。结果:共纳入12篇文献。Meta分析显示:西尼地平在减少尿白蛋白产生方面优于L-CCB(MD=-30.59,95%CI:-35.27^-25.90,P<0.000 01),差异有统计学意义。西尼地平在降低患者心率(HR)方面优于L-CCB(MD=-2.47,95%CI:-4.11^-0.82,P=0.003),差异有统计学意义。结论:西尼地平较L-CCB能更有效减少高血压患者尿白蛋白的产生和更明显降低患者心率。因此,西尼地平较L-CCB更有利于保护患者肾脏功能及降低心血管事件风险,能给患者带来更多的益处。

Objective： To evaluate the difference effects of cilnidipine and L-type calcium channel blockers（ L-CCBs） on renal function and heart rate in hypertension patients. Methods： The clinical randomized controlled trials（ RCTs） of cilnidipine and L-CCBs for treating hypertension were selected from Pub Med,Embase,Science Direct,Ebsco,Springer,Cochrane Library,Medline,Wanfang databases from the date of databases＇ establishment to September 2017. The qualities of the literatures were evaluated following the Jadad standard. Rev Man 5. 3 software was used for Meta-analysis. Results： A total of 12 RCTs were included. Meta-analysis showed that cilnidipine significantly improved urinary albumin compare with L-CCBs（ MD =-30. 59,95% CI：-35. 27 to-25. 90,P 0. 000 01）. Cilnidipine was superior to L-CCBs in reducing heart rate（ HR,MD =-2. 47,95% CI：-4. 11 to-0. 82,P = 0. 003）. Conclusion： Cilnidipine is more effective in improving urinary albumin and decreasing heart rate compared with L-CCBs. So,cilnidipine is more advantageous to protect patients＇ kidney function and reduce therisk of cardiovascular events,thus bringing more benefits to patients.