摘要
目的:系统评价他汀类药物治疗对冠心病患者心房颤动(房颤)新发或复发的预防作用。方法:检索Pubmed、CNKI数据库中关于他汀对冠心病房颤预后影响的临床试验,检索时间截止至2015年2月。根据纳入和排除标准,由2位评价员独立筛选文献、提取资料并对纳入的试验进行质量评价,最后将提取的资料用RevMan5.1软件进行Meta分析。结果:经检索和筛选,共纳入14篇临床试验,其中8篇为他汀对冠心病新发房颤的影响,3篇为他汀对冠心病合并房颤的房颤复发的影响,另外3篇为他汀对冠心病患者(包括合并或不合并房颤的所有冠心病患者)的房颤发生的影响。对不合并房颤的冠心病患者和合并房颤的冠心病患者分别进行Meta分析,结果显示,他汀治疗对冠心病新发房颤[OR=0.62,95%CI:(0.52,0.75),Z=4.99,P<0.00 001]和房颤复发[OR=0.15,95%CI:(0.08,0.27),Z=6.24,P<0.00 001]均有预防作用并能显著降低其发生风险,差异有统计学意义。对所有纳入的14篇文献进行Meta分析,共207 868例患者,其中93 330(44.90%)例患者使用他汀治疗,Meta分析结果显示:他汀治疗组房颤发生率11.44%,对照组房颤发生率16.08%,两组差异有统计学意义[OR=0.58,95%CI:(0.50,0.68),P<0.00 001],且结论的稳定性较好。结论:他汀治疗能够有效降低冠心病患者的房颤新发及复发风险。
Objective：To evaluate the effects of statins therapy in patients with coronary disease.Method：Published literature before February 2015 on relevant clinical trials was retrieved via electronic and manual search in databases Pubmed and CNKI.Two reviewers independently identified articles according to the inclusion and exclusion criteria,extracted the data,assessed the quality of the included studies,and then conducted meta-analysis using RevMan 5.1 software.Result：A total of 14 trials were included,8 trials for statin effected on the new-onset atrial fibrillation in coronary diseases and 3 trials were for statin effected on recurrence of atrial fibrillation in coronary diseases.Then we performed meta-analysis,respectively.The results indicated that statins therapy could reduce the incidence of atrial fibrillation in coronary disease with or without atrial fibrillation.A significant difference was present between the two group（OR=0.62,95%CI（0.52,0.75）,Z=4.99,P〈0.000 01）and（OR=0.15,95%CI（0.08,0.27）,Z=6.24,P〈0.000 01）.A total of 14 trials,involving 207 868 patients were included,the use of stains group were 93330（44.90%）.The result of Meta-analyses showed that the incidence of atrial fibrillation was 11.44%in statin-treated group as compared with 16.08% in control group.A significant difference was present between the two group（OR=0.58,95%CI（0.50,0.68）,P〈0.000 01）,and demonstrated the result was stable.Conclusion：For coronary disease,patients taking statins had a lower incidence of atrial fibrillation than those not taking statins.Our study also suggests another possible benefit from primary and secondary prevention of atrial fibrillation with statins therapy.
出处
《临床心血管病杂志》
CAS
CSCD
北大核心
2015年第11期1186-1191,共6页
Journal of Clinical Cardiology
基金
国家自然科学基金青年项目资助(No:81100078)
广州珠江科技新星资助计划项目(No:2012J2200063)
