奈必洛尔与第二代β受体阻滞剂治疗高血压效果比较的Meta分析

Meta analysis on the effect comparison of Nebivolol and the second generation of beta blockers in the treatment of hypertension

目的通过Meta分析的方法,比较奈必洛尔与第二代β受体阻滞剂治疗高血压的效果。方法检索建库至2015年12月PubMed、Cochrane Library、EMbase、中国知网(CNKI)、中国生物医学文献数据库(CBM)、万方数据(WanFang Data),筛选奈必洛尔与美托洛尔等第二代β受体阻滞剂治疗高血压患者的病例对照研究,获取患者用药后血压变化、心率变化、不良反应等资料,应用RevMan 5.3软件进行荟萃分析。结果共纳入7篇文献,包含481例高血压患者。奈必洛尔与二代β受体阻滞剂在治疗高血压患者后收缩压[MD=0.18,95%CI(-1.50,1.86),P=0.83]比较,差异无统计学意义,舒张压[MD=1.07,95%CI(0.24,1.90),P=0.01]、心率[MD=-4.20,95%CI(-5.19,-3.20),P <0.00001]比较差异有统计学意义,不良反应发生情况[MD=0.52,95%CI(0.27,0.99),P=0.05]比较,差异无统计学意义。结论奈必洛尔治疗高血压后,舒张压下降幅度大于第二代β受体阻滞剂,心率变化值更小,安全性相当。

Objective To compare the effect of Nebivolol and the second generation of beta blockers in the treatment of hypertension by Meta analysis. Methods The databases of PubMed, Cochrane Library, EMbase, China National Knowledge Infrastructure (CNKI), Chinese biomedicine literature database (CBM), WanFang data were electronically searched from inception to December 2015. The case-control studies about Nebivolol and the second generation of beta blockers such as Metoprolol in the treatment of hypertension were screened, and the data of changes of blood pressure, heart rate after administration and adverse reactions was obtained, then the Meta-analysis was performed by RevMan 5.3 software. Results Seven studies were enrolled including 481 cases with hypertension. After treatment, there was no statistically significant difference of systolic pressure [MD = 0.18,95%CI (-1.50, 1.86),P = 0.83], while there were statistically significant differences of diastolic pressure [MD = 1.07,95%CI (0.24, 1.90), P = 0.01], heart rate [MD =-4.20, 95%CI (-5.19,-3.20), P < 0.00001], and there was no statistically significant difference of adverse reactions [MD = 0.52, 95%CI (0.27, 0.99), P = 0.05] between Nebivolol and the second generation of beta blockers in the treatment of patients with hypertension. Conclusion The falling range of diastolic blood pressure treated by Nebivolol in patients with hypertension is bigger than the second generation of beta blockers, the change of heart rate is less, the security of Nebivolol and the second generation of beta blockers is almost the same.