瑞舒伐他汀与阿托伐他汀治疗冠心病合并高脂血症疗效比较的Meta分析

Therapeutic effect of rosuvastatin and atorvastatin on coronary heart disease complicated with hyperlipidemia:a meta analysis

目的对瑞舒伐他汀与阿托伐他汀治疗冠心病(CHD)合并高脂血症(HPL)疗效与安全性比较进行Meta分析。方法检索中国知网、万方数据库、维普数据库、中国生物医学数据库、PubMed自数据库建立至2020年1月的文献,筛选有关瑞舒伐他汀与阿托伐他汀治疗冠心病合并高脂血症的临床研究。试验组为瑞舒伐他汀治疗,对照组阿托伐他汀治疗。对纳入的文献提取资料及质量评价,采用Revman5.3软件进行Meta分析。用比值比(OR)和95%可信区间(95%CI)评价结局指标,连续性变量运用平均差值(MD)。采用漏斗图对发表偏倚进行评估。结果共纳入14篇符合标准的文献,共1487例患者,其中试验组752例,对照组735例。与对照组相比,试验组可显著改善患者临床症状缓解率(OR=5.88,95%CI:3.31~10.43,P<0.05),降低血清总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL-C)水平(MD=-0.28,95%CI:-0.31^-0.24,P<0.05;MD=-0.36,95%CI:-0.39^-0.33,P<0.05;MD=-0.65,95%CI:-0.69^-0.61,P<0.05);同时可抑制HDL-C、NO的下降水平(MD=0.30,95%CI:0.28~0.33,P<0.05;MD=13.19,95%CI:11.70~14.68,P<0.05)。结论瑞舒伐他汀治疗CHD合并HPL的临床有效率更高,调脂效果更好。

Objective To conduct a meta-analysis of the efficacy and safety of rosuvastatin and atorvastatin in the treatment of coronary heart disease(CHD)with hyperlipidemia(HPL).Methods The literatures were retrieved from China HowNet,Wanfang Database,Weipu Database,China Biomedical Database and PubMed from the database establishment to January 2020 and those related to the rosuvastatin and atorvastatin in the treatment of coronary heart disease with hyperlipidemia were screened.In the clinical study,the experimental group was treated with rosuvastatin and the control group was treated with atorvastatin.For the extracted data and quality evaluation of the included literature,meta analysis was performed using Revman5.3 software.Heterogeneity among studies was judged byχ2 test.The odds ratio(OR)and 95%confidence interval(95%CI)were used to evaluate the outcome indicators,and the continuous variable was used to calculate the average difference(MD).A funnel chart was used to assess publication bias.Results A total of 1487 patients were included in the standard-matched literature,including 752 patients in the test group and 735 patients in the control group.Compared with the control group,patient's clinical symptom in the test group were significantly improved(OR=5.88,95%CI:3.31~10.43,P<0.05);serum total cholesterol(TC),triglyceride(TG),low density lipoprotein(LDL-C)were reduced(MD=-0.28,95%CI:-0.31 to-0.24,P<0.05;MD=-0.36,95%CI:-0.39 to-0.33,P<0.05;MD=-0.65,95%CI:-0.69^-0.61,P<0.05).At the same time,the decline of HDL-C and NO was inhibited(MD=0.30,95%CI:0.28~0.33,P<0.05;MD=13.19,95%CI:11.70-14.68,P<0.05).Conclusion Rosuvastatin has higher clinical efficacy and better lipid-lowering effect in treating CHD combined with HPL.