ω-3脂肪酸类药物联用他汀类药物用于血脂异常的系统评价

Effects ofω-3 fatty acids combined with statins on serum lipid composition:a systematic review

目的评价ω-3脂肪酸类药物与他汀类药物(以下简称他汀)联用治疗的血脂异常的有效性和安全性。方法系统检索PubMed、Embase、Cochane Library、中国知网、万方数据、维普等中英文数据库,纳入已发表的关于ω-3脂肪酸类药物联合他汀用于血脂异常的临床研究,提取资料后进行质量评价,采用Review Manager 5.3软件进行统计分析。结果共纳入11篇临床研究。研究发现,与单用他汀相比,ω-3脂肪酸类药物和他汀联用可以显著降低血脂异常人群中甘油三酯(TG)、总胆固醇(TC)和极低密度脂蛋白-胆固醇(VLDLC)水平。同时,二者联用时不良事件数或严重不良事件数没有显著增加,其中胃肠道相关不良事件发生率稍高。亚组分析发现,TG基线较高的患者,高剂量(4 g/d)ω-3脂肪酸类药物联用低剂量他汀组TG水平的降低更显著。结论ω-3脂肪酸类药物和他汀联用在血脂异常人群中有良好的有效性和安全性,可作为高甘油三酯血症患者的用药选择。

Objective To assess the efficacy and safety ofω-3 fatty acids combined with statins in the treatment of patients with dyslipidemia.Methods PubMed,Embase,Cochrane Library,CNKI,Wangfang and VIP databases were systematically searched.All kinds of clinical trials of combination ofω-3 fatty acids in patients with dyslipidemia treated with statin were included.Quality evaluation and data analyzed was conducted with Review Manager 5.3 software.Results A total of 11 clinical studies were included.Compared with statins alone,the combination ofω-3 fatty acid drugs and statins significantly reduced triglycerides(TG),total cholesterol(TC),and very low density lipoproteins-cholesterol(VLDL-C)levels in patients with dyslipidemia.At the same time,the number of adverse events or serious adverse events did not increase significantly when they were combined,and the incidence of gastrointestinal related adverse events was slightly higher.Subgroup analysis showed that patients with higher TG baseline decreased more significantly with higher doses ofω-3 fatty acids and lower dose statins.Conclusion The combination ofω-3 fatty acids and statins have better efficacy and safety in patients with dyslipidemia,and can be used as a drug choice for patients with hypertriglyceridemia.