摘要
目的系统评价吲达帕胺与钙通道阻滞剂(CCB)比较治疗高血压的疗效和安全性。方法计算机检索h e Cochrane Library(2011年第3期)、PubMed、EMbase、Web for Science、CBM、CNKI、VIP和WanFang Data,检索时限截至2011年8月,纳入吲达帕胺比较CCB(包括氨氯地平、非洛地平、硝苯地平、尼莫地平和尼群地平)治疗高血压的随机对照试验(RCT)。由2位研究人员根据纳入与排除标准独立进行文献筛选、数据提取、质量评价并交叉核对结果,然后采用RevMan 5.1软件进行Meta分析。结果共纳入42个RCT。Meta分析结果显示除吲达帕胺的舒张压降低值低于非洛地平外,其余两组显效率、总有效率、收缩压降低值、舒张压降低值差异均无统计学意义[显效率:RR=1.01,95%CI(0.93,1.09),P=0.90;总有效率:RR=1.01,95%CI(0.96,1.06),P=0.69;收缩压降低值:MD=–1.21,95%CI(–3.00,0.59),P=0.19;舒张压降低值:MD=–0.87,95%CI(–1.89,0.15),P=0.09]。但吲哒帕胺的不良反应发生率低于硝苯地平、尼莫地平和尼群地平,其差异有统计学意义。结论基于当前临床证据,吲达帕胺单药治疗高血压患者的疗效与CCB相似,安全性优于CCB。
ObjectiveTo systematically assess the effectiveness and safety of indapamide versus calcium channel blockers （CCBs） for the treatment of hypertension. MethodsDatabases including The Cochrane Library （Issue 3, 2011）, PubMed, EMbase, Web of Science, CBM, CNKI, VIP and WanFang Data were electronically searched from inception to Nov. 2011, for the randomized controlled trials （RCTs） on indapamide versus CCBs for hypertension. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed the methodological quality of included studies. Then, meta-analysis was performed using RevMan 5.1 software. ResultsIn total, 42 RCTs were included. The results of meta-analysis indicated that, the ΔDBP of indapamide was lower than that of felodipine; and the rest were similar between the two groups in the excellent rate, total effective rate, ΔSBP and ΔDBP, without significant difference （excellent rate： RR=1.01, 95%CI 0.93 to 1.09, P=0.90; total effective rate： RR=1.01, 95%CI 0.96 to 1.06, P=0.69; ΔSBP： MD= –1.21, 95%CI –3.00 to 0.59, P=0.19; ΔDBP： MD= –0.87, 95%CI –1.89 to 0.15, P=0.09）. However, the incidence of indapamide was lower than those of nifedipine, nimodipine and nitrendipine, with significant differences. ConclusionBased on current clinical evidence, for hypertension, the effectiveness of indapamide is similar to CCBs, but safer than CCBs.
出处
《中国循证医学杂志》
CSCD
2014年第1期34-43,共10页
Chinese Journal of Evidence-based Medicine
基金
科技部"十一五"科技支撑项目--基层医疗机构主要基本药物合理使用评价和研究(编号:2009BAI76B030202)
关键词
吲达帕胺
钙通道阻滞剂
高血压
系统评价
META分析
随机对照试验
Indapamide
Calcium channel blocker （CCB）
Hypertension
Systematic review
Meta-analysis
Rand-omized controlled trial
