摘要
目的:评价前列地尔治疗慢性肾脏病(CKD)的有效性和安全性。方法:检索知网、万方、维普、Embase、Pubmed、Cochrane、web of science数据库,收集前列地尔治疗CKD的随机对照试验。由两名研究者独立选择试验、提取资料并交叉核对,而后评价纳入研究的质量和提取有效数据,用Rev Man5.3进行Meta分析。结果:纳入临床研究文献9篇,共计591例患者。Meta分析结果显示,在改善肾功能方面,实验组内生肌酐清除率[SMD=0.57,95%CI(0.35,0.78),P<0.00001]显著高于对照组,血清肌酐[SMD=-0.52,95%CI(-0.71,-0.33),P<0.00001]、24h尿蛋白定量[SMD=-0.57,95%CI(-0.76,-0.38),P<0.00001]和血尿素氮[SMD=-0.57,95%CI(-0.74,-0.40),P<0.00001]均显著低于对照组;在改善肾血流动力学方面,实验组左肾动脉直径[SMD=2.25,95%CI(1.96,2.55),P<0.00001]和右肾动脉直径[SMD=2.92,95%CI(1.48,4.37),P<0.0001]均显著大于对照组,左肾动脉阻力[WMD=-1.45,95%CI(-1.69,-1.22),P<0.00001]和右肾动脉阻力[SMD=-1.64,95%CI(-1.91,-1.38),P<0.00001]均显著低于对照组;无重大不良反应发生,实验组与对照组不良反应比较差异无统计学意义[OR=0.67,95%CI(0.27,1.71),P=0.41]。结论:前列地尔治疗CKD临床疗效显著,能有效改善肾功能和肾血流循环,临床安全性较好,但由于纳入文献的质量较低,样本量有限,仍需进一步研究。
Objective:To evaluate the efficacy and safety of alprostadil in the treatment of CKD.Methods:CNKI,WANFANG,VIP,Embase,Pubmed,Cochrane and web of science databases were searched to collect randomized controlled trials(RCTs)of alprostadil curing CKD.The selection of studies,assessment of methodological quality and data extraction were performed independently by two reviewers.According to predefined inclusion and exclusion criteria Cochrane systematic review.The methodological quality assessment was undertaken,and meta-analyses were performed by the Cochrane Collaboration’s RevMan5.3 software.Results:The literature included 9 RCTs with a total of 591 cases.Meta-analysis results show that the Ccr in experimental group[SMD=0.57,95%CI(0.35,0.78)]was significantly higher than control group(<0.00001).The Scr[SMD=-0.52,95%CI(-0.71,-0.33),<0.00001],24-Upro[SMD=-0.57,95%CI(-0.76,-0.38),<0.00001]and BUN[SMD=-0.57,95%CI(-0.74,-0.40),<0.00001]in experimental group were all significantly lower than control group.In terms of improving renal hemodynamics,the diameter of the left renal artery[SMD=2.25,95%CI(1.96,2.55),<0.00001]and the diameter of the right renal artery[SMD=2.92,95%CI(1.48,4.37),<0.0001]were significantly greater than the control group.The left renal artery resistance[SMD=-1.45,95%CI(-1.69,-1.22),<0.00001]and right renal artery resistance[SMD=-1.64,95%CI(-1.91,-1.38),<0.00001]were significantly lower than the control group.All studies included no report any significant adverse reactions,There was no statistically significant difference in adverse reactions between the two groups[OR=0.67,95%CI(0.27,1.71),=0.41].Conclusion:Alprostadil in the treatment of CKD is superior to the conventional therapy,which improves the renal function,kidney fluid circulation and has good safety.Due to the low quality of the included literature and limited sample size,further research is still needed.
作者
黄川生
张雪
陈卫军
王新春
HUANG Chuan-sheng;ZHANG Xue;CHEN Wei-jun;WANG Xin-chun(Shihezi University School of Pharmacy,Xinjiang Shihezi,832002)
出处
《农垦医学》
2018年第6期485-493,共9页
Journal of Nongken Medicine
关键词
前列地尔
慢性肾脏病
系统评价
Alprostadil
Chronic kidney disease
Meta-analysis
