摘要
目的系统性评价他汀类药物用于治疗急性呼吸窘迫综合征（ARDS）患者的有效性和安全性。方法计算机检索和手工检索收集有关他汀类药物治疗ARDS患者的随机对照研究（RCT）文献,按纳入与排除标准选择文献,评价纳入文献质量,提取资料,采用Rev Man 5.3软件对数据进行Meta分析。结果共纳入5篇RCT研究文献,共入选1 489例患者,其中他汀类治疗组709例,安慰剂对照组780例。Meta分析显示,与安慰剂对照组比,他汀类治疗组无法降低ARDS患者病死率（RR=1.01,95%CI 0.86~1.18,P=0.91）,无法改善ARDS患者的氧合状态（MD=3.92,95%CI-14.10~21.94,P=0.67）,也无法缩短其非机械通气时间（MD=0.65,95%CI-0.20~1.50,P=0.13）以及无肺外器官功能障碍时间（MD=1.20,95%CI-1.46~3.87,P=0.38）。安全性评价显示他汀类治疗组肌酸激酶（CK）值显著升高（MD=6.92,95%CI 5.77~8.07,P〈0.000 01）。结论与安慰剂对照组相比,他汀类药物无法改善ARDS患者的预后,其安全性亦需进一步评估。
Objective To evaluate the effects and safety of statins in patients with acute respiratory distress syndrome（ ARDS）. Methods Literatures in English and Chinese concerning randomized controlled trials（ RCTs） on statins in ARDS patients were retrieved by electronic and manual search. All related data were extracted. Meta-analysis was conducted using the statistical software Rev Man 5. 3 on the basis of strict quality evaluation. Results Five RCTs involving 1489 ARDS patients were included,with709 patients in the statins group and 780 patients in the placebo control group. Compared with the control group,statins did not improve the survival of ARDS patients [risk ratio（ RR） 1. 01,95% confidence interval（ CI） 0. 86 to 1. 18,P = 0. 91）,while the improvement of oxygenation [mean difference（ MD）3. 92,95% CI- 14. 10 to 21. 94,P = 0. 67 ],ventilator-free days（ MD 0. 65,95% CI- 0. 20 to 1. 50,P = 0. 13） and non-pulmonary organ failure-free days（ MD 1. 20,95% CI- 1. 46 to 3. 87,P = 0. 38）exhibited no differences between the statins group and the control group. However statins were associated with significant elevation of creatine kinase（ MD 6. 92,95% CI 5. 77 to 8. 07,P 0. 000 01）. Conclusion This study demonstrates that statins can not improve outcomes of ARDS patients,and the safety of statins still needs further evaluation.
作者
董亮
李朗
严洁
严正
张秀红
Dong Liang Li Lang Yan Jie Yan Zheng Zhang Xiuhong(Department of Critical Care Medicine, Affiliated Wuxi People＇ s Hospital of Nanjing Medical University, Wuxi, Jiangsu, 214023, China)
出处
《中国呼吸与危重监护杂志》
CAS
北大核心
2016年第6期583-588,共6页
Chinese Journal of Respiratory and Critical Care Medicine
基金
国家自然科学基金(编号:81400054)
江苏省自然科学基金(编号:BK20140122)
无锡市科技局项目(编号:CSE31N1503)
无锡市卫生局妇幼保健项目(编号:FYKY201405)
