摘要
目的系统评价阿托伐他汀联合曲美他嗪治疗冠心病心绞痛的疗效及安全性。方法计算机检索中国知网(CNKI)、万方数据库、维普数据库,搜索阿托伐他汀联合曲美他嗪治疗冠心病心绞痛的随机对照试验,依据Jadad量表评价纳入文献质量并提取有效数据。采用Rev Man 5. 3进行Meta分析。结果共纳入18篇研究,共计1 848例患者。Rev Man 5. 3软件对临床疗效、心血管事件发生情况、心绞痛发作情况、血脂(TC、TG、LDL-C、HDL-C)、心功能改善情况[包括心脏超声指标左室收缩末期内径(LVESD)、左室舒张末期内径(LVEDD)]及不良反应进行Meta分析,结果显示,与单纯阿托伐他汀治疗比较,阿托伐他汀联合曲美他嗪可降低心血管事件发生率[OR=0. 19,95%CI(0. 11,0. 35),P <0. 01],减少心绞痛发作频率[WMD=-1. 52,95%CI(-1. 84,-0. 99),P <0. 01]及持续时间[WMD=-1. 80,95%CI(-2. 20,-1. 50),P <0. 01],提高临床有效率[OR=4. 78,95%CI(3. 54,6. 47),P <0. 01];血脂及心脏超声指标显示,阿托伐他汀联合曲美他嗪能够更好的改善患者的LVEDD[WMD=-2. 69,95%CI(-4. 39,-0. 98),P <0. 01]、LVESD[WMD=-6. 92,95%CI(-11. 82,-2. 02),P <0. 01],其降低患者血清TC、TG、LDL-C水平优于阿托伐他汀单药治疗(P <0. 01),但对改善患者血清HDL-C水平的差异无统计学意义(P=0. 17)。阿托伐他汀联合曲美他嗪能明显降低患者的不良反应发生率[OR=0. 33,95%CI(0. 13,0. 85),P=0. 02]。结论阿托伐他汀联合曲美他嗪较单纯阿托伐他汀治疗冠心病心绞痛具有更好的临床治疗效果,且安全可靠。
Objective To evaluate efficacy and safety of Atorvastatin combined with trimetazidine Sibutramine treating angina pectoris of coronary heart disease. Methods Of computer retrieval China National Knowledge Infrastructure (CNKI), Wanfang database, VIP database and search atorvastatin statins combined with trimetazidine trimetazidine in the treatment of angina pectoris of coronary heart disease: a randomized controlled trial, according to Jadad scale to evaluate the quality of the included studies and extracted data. Meta analysis was performed using RevMan 5.3. Results In accordance with the inclusion criteria were included in the 18 study, a total of 1 848 patients. The software of RevMan 5.3 on cardiovascular events incidence, clinical curative effect, angina pectoris, blood lipid [total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C)], the improvement of cardiac function [including cardiac index left ventricular end diastolic diameter (LVEDD), left ventricular end systolic diameter (LVESD)] and the adverse reactions of meta analysis showed that compared with pure atorvastatin, atorvastatin combined with trimetazidine can reduce the incidence of cardiovascular events [OR=0.19, 95% Cl (0.11, 0.35), P<0.01], reduce seizure frequency and duration of angina [WMD=-1.52, 95% CI (-1.84,-0.99), P<0.01;WMD=-1.80, 95% CI (-2.20,-1.50), P<0.01], improve the clinical efficiency of [OR=4.78, 95% Cl (3.54, 6.47), P<0.01] display. Blood lipid and cardiac ultrasound index show that atorvastatin combined with trimetazidine can better improve the patient′s LVEDD [WMD=-2.69, 95% CI (-4.39,-0.98), P<0.01] LVESD [WMD=-6.92, 95% CI(-11.82,-2.02), P<0.01]. The decrease of serum level of TC, TG , LDL-C was better than atorvastatin monotherapy, but there were no statistically significant differences in the improvement level of serum HDL-C in the included patients (P=0.17). In the included studies, atorvastatin combined with trimetazidine can effectively reduce the incidence of adverse reactions in patients [OR=0.33, 95% CI (0.13, 0.85), P=0.02]. Conclusions Atorvastatin combined with trimetazidine is safer and more effective than atorvastatin alone in the treatment of coronary heart disease angina pectoris.
作者
王尚中
张涵
杨海波
陈华峰
盛洁
Wang Shangzhong;Zhang Han;Yang Haibo;Chen Huafeng;Sheng Jie(Department of Cardiovascular Internal Medicine,Anhui Province Police General Hospital,Hefei 230000,China)
出处
《中国医师杂志》
CAS
2019年第2期239-242,共4页
Journal of Chinese Physician
