摘要
目的:循证评价碳酸镧在非透析慢性肾脏病患者中的有效性和安全性。方法:系统检索Pub Med,Embase,Cochrane Library以及CNKI,CBM和Wan Fang数据库,获取公开发表的相关随机对照研究,对其方法学质量进行评估,对符合条件的数据进行Meta分析。结果:纳入9篇研究,共534例患者。与安慰剂相比,碳酸镧可显著降低基线患高磷血症的患者的血磷水平[加权均数差WMD:-0.52(-0.92,-0.12)mmol·L-1,P=0.01],但对基线血磷水平正常的患者没有影响[WMD:-0.00(-0.11,0.10)mmol·L-1,P=0.95],同时可显著降低钙磷乘积(Ca x P)水平;与含钙磷结合剂相比,碳酸镧可显著降低血清全段甲状旁腺素(intact parathyroid hormone,i PTH)和血清全段成纤维细胞生长因子23(intact fibroblast growth factor23,i FGF23)水平,高钙血症发生率显著降低[风险比RR:0.10(0.01,1.68),P=0.11]。全因死亡率和不良事件与安慰剂、含钙磷结合剂和司维拉姆相比均无显著差异。结论:基于现有证据,碳酸镧在非透析肾脏患者中具有良好的有效性和安全性。
Objective： To evaluate the efficacy and safety of lanthanum carbonate in non-dialysis patients with chronic kidney disease. Methods： Medline,Embase,Web of Sciences,the Cochrane Library and Chinese literature databases（ CNKI,CBM,Wanfang） were systematically searched. Related randomized controlled studies were included. The quality of included studies were evaluated. Meta-analysis was conducted if studies were qualified to be combined. Results： Nine studies were included in the systematic review,including a total of 534 patients. Compared with placebo,lanthanum carbonate significantly reduced serum phosphate levels in baseline hyperphosphatemic patients [WMD- 0. 52（- 0. 92,- 0. 12） mmol·L^-1,P = 0. 01],but not in normophosphatemic patients [WMD- 0. 00（- 0. 11,0. 10） mmol·L^-1,P = 0. 95]; it also reduced Ca x P levels in nondialysis patients. Compared with calcium-containing phosphate binders,lanthanum carbonate significantly reduced i PTH and i FGF23 levels and incidence of hypercalcemia [RR 0. 10（ 0. 01,1. 68）,P = 0. 11]. All-cause mortality and adverse events were not different significantly compared with placebo,calcium-containing phosphate binders or sevelamer. Conclusion： Lanthanum carbonate is efficacious and safe in non-dialysis patients with chronic kidney disease according to currently available evidence.
出处
《中国新药杂志》
CAS
CSCD
北大核心
2016年第2期193-197,共5页
Chinese Journal of New Drugs
关键词
碳酸镧
非透析
慢性肾脏病
系统评价
lanthanum carbonate
non-dialysis
chronic kidney disease
systematic review
