他汀類(lèi)藥物治療頸動(dòng)脈斑塊的Meta分析

摘要: 目的 系統(tǒng)評(píng)價(jià)他汀類(lèi)藥物（以阿托伐他汀鈣為例）治療頸動(dòng)脈斑塊的臨床療效及不良反應(yīng)，為臨床合理用藥提供依據(jù)。 方法 計(jì)算機(jī)檢索的數(shù)據(jù)庫(kù)包括CNKI、CBM、WanFang Date，時(shí)限均為1997年-2013年3月，納入阿托伐他汀鈣治療頸動(dòng)脈斑塊的隨機(jī)、雙盲對(duì)照性試驗(yàn)（RCT），而后進(jìn)行篩選文獻(xiàn)、提取所需資料和評(píng)價(jià)納入文獻(xiàn)的質(zhì)量，進(jìn)行Meta分析采用分析軟件Rev Man5.0。 結(jié)果 共納入9個(gè)RCT，共1055例患者。Meta分析結(jié)果顯示：①頸動(dòng)脈內(nèi)-中膜厚度大?。↖MT）：共納入7個(gè)研究，分析結(jié)果顯示阿托伐他汀鈣能顯著減少I(mǎi)MT[MD=-0.31,95%Cl（-0.52,-0.11），P=0.003]；②斑塊面積：納入4個(gè)研究，阿托伐他汀鈣能顯著減少斑塊面積[MD=-5.22,95%Cl（-11.17,0.74），P=0.09]；③CRP：4個(gè)研究被納入，阿托伐他汀鈣能明顯的降低血中CRP水平[MD=-2.38,95%Cl（-5.04,0.28），P=0.08]；④斑塊積分：共納入研究4個(gè)，試驗(yàn)組斑塊積分減小顯著[MD=-0.43,95%Cl（-1.82,0.97），P=0.55]；⑤對(duì)血脂中低密度脂蛋白的影響：共納入5個(gè)研究，降低血脂中LDL-C阿托伐他汀鈣具有良好的效果[MD=-1.11,95%Cl（-2.04,-0.17），P=0.02];⑥不良反應(yīng)：納入4個(gè)研究，阿托伐他汀鈣不良反應(yīng)輕[MD=4.77,95%Cl(1.02,22.37),P=0.05]。 結(jié)論 阿托伐汀鈣對(duì)存在頸動(dòng)脈斑塊的患者的治療具有良好的治療效果，可以用來(lái)防治頸動(dòng)脈斑塊發(fā)生與發(fā)展，降低腦卒中等缺血性腦血管疾病的發(fā)生率。

關(guān)鍵詞: 阿托伐他汀鈣 頸動(dòng)脈斑塊 Meta分析

Statin therapy for carotid plaques :A Meta-Analysis

Abstract : Objective To eva luate the efficary and Adverse reactions of Statins (atorvastatin calcium) in the treatment of Carotid artery plaques ,so as to provide references for clinical practice. Methods In order to collect the randomized controlled trials (RCTS) we are looking for some databases, including CNKI,CBM ,WanFang Date .The time form 1997 to March,2013 .The RCTS are about Atorvastatin calcium treatment of carotid plaques.The last, according to the Cochrane system to extract data and quality eva luation in literature, and the Meta-analyses were performed with Rev Man5.0 software. Results Nine randomized trials involving 1055 patients were included.The results of meta-analyses showed the following : Atorvastatin calcium were associated with a reduction of carotid intima-media thickness(IMT)[MD=-0.31,95%Cl（-0.52,-0.11),P=0.003];Atorvastatin calcium reduced the area of plaque compared to the control group [MD=-5.22,95%Cl（-11.17,0.74),P=0.09];Atorvastatin calcium reduced C-reactive protein compared to the control group [MD=-2.38,95%Cl（-5.04,0.28），P=0.08];For reducing plaque integral atorvastatin calcium has obvious curative effect[MD=-0.43,95%Cl（-1.82,0.97），P=0.55];In terms of lowering LDL-C,we can find atorvastatin calcium has a good curative effect [MD = 1.11, 95% ci (2.04, 0.17), P = 0.02); In addition ,adverse effects of Blank group is less than the experimental group,[MD=4.77,95%Cl(1.02,22.37),P=0.05],but We can find that atorvastatin calcium light adverse reactions . Conclusion Atorvastatin calcium statins significantly reduce the size of carotid plaques, the film thickness in the carotid artery -, lower CRP levels, blood lipid, etc, used for prevention and treatment of carotid artery plaque occurrence and development, reduce the incidence of cerebral apoplexy has significant curative effect.
Key words : Atorvastatin calcium Carotid plaques Meta-analysis