他汀类药物治疗颈动脉斑块的meta分析.doc

他汀类药物治疗颈动脉斑块的Meta分析

摘要: 目的 系统评价他汀类药物（以阿托伐他汀钙为例）治疗颈动脉斑块的临床疗效及不良反应，为临床合理用药提供依据。 方法 计算机检索的数据库包括CNKI、CBM、WanFang Date，时限均为1997年-2013年3月，纳入阿托伐他汀钙治疗颈动脉斑块的随机、双盲对照性试验（RCT），而后进行筛选文献、提取所需资料和评价纳入文献的质量，进行Meta分析采用分析软件Rev Man5.0。 结果 共纳入9个RCT，共1055例患者。Meta分析结果显示：①颈动脉内-中膜厚度大小（IMT）：共纳入7个研究，分析结果显示阿托伐他汀钙能显著减少IMT[MD=-0.31,95%Cl（-0.52,-0.11），P=0.003]；②斑块面积：纳入4个研究，阿托伐他汀钙能显著减少斑块面积[MD=-5.22,95%Cl（-11.17,0.74），P=0.09]；③CRP：4个研究被纳入，阿托伐他汀钙能明显的降低血中CRP水平[MD=-2.38,95%Cl（-5.04,0.28），P=0.08]；④斑块积分：共纳入研究4个，试验组斑块积分减小显著[MD=-0.43,95%Cl（-1.82,0.97），P=0.55]；⑤对血脂中低密度脂蛋白的影响：共纳入5个研究，降低血脂中LDL-C阿托伐他汀钙具有良好的效果[MD=-1.11,95%Cl（-2.04,-0.17），P=0.02];⑥不良反应：纳入4个研究，阿托伐他汀钙不良反应轻[MD=4.77,95%Cl(1.02,22.37),P=0.05]。 结论 阿托伐汀钙对存在颈动脉斑块的患者的治疗具有良好的治疗效果，可以用来防治颈动脉斑块发生与发展，降低脑卒中等缺血性脑血管疾病的发生率。

关键词: 阿托伐他汀钙 颈动脉斑块 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