摘要
目的系统评价非诺贝特对不同人群肾功能的影响，为临床上高尿酸血症治疗方案的选择提供参考。方法计算机检索PubMed（1966～2013）、EMbase（1984～2013）、TheCochraneLibrary（2012年第1期）、CBM（1978～2013）和CNKI（1989～2013）等数据库，同时手工检索《中西医结合杂志》及国内肾脏疾病相关杂志，纳入非诺贝特干预相关随机或半随机对照试验。按Cochrane系统评价方法，南2名评价员独立进行文献筛选、资料提取和评价纳入研究的方法学质量后，采用RevMan5．0软件进行Meta分析。结果共纳入16个研究，包括346例患者。Meta分析结果显示：①经非诺贝特治疗后，患者血清尿酸改善优于对照组[WMD=48．68，95％CI（10．02，87．34），P〈0．00001]；内生肌酐清除率较对照组下降[WMD=8．88，95％CI（1．29，16．47），P=0．002]；血清肌酐的变化与对照组差异无统计学意义[WMD=I．78，95％CI（-2．86，6．42），P=0．4510②不良反应主要有胃肠道不适、皮疹、GPT、转氨酶等一过性升高，但大多症状轻微。结论非诺贝特对于降低m尿酸有较好的疗效，但由于纳入文献方法学质最不高，确切疗效及有关毒副作用有待于设计严格的多中心、大样本、随机双盲临床对照试验进一步证实。
Objective To systematically review the effects of fenofibrate on kidney function in various populations, so as to provide references for selecting the methods of treating hyperuricemia. Methods Such databases as PubMed （1966- 2013）, EMbase （1984-2013）, The Cochrane Library （Issue 1, 2012）, CBM （1978-2013）, and CNKI （1989-2013） were elec- tronically searched for relevant randomized controlled trials or non-randomized controlled trials on fenofibrate for treating hyperuricemia. According to the Cochrane methods, two reviewers independently screened literature, extracted data, and assessed the methodological quality of included studies. Then, meta-analysis was performed using RevMan 5.0 software. Re- suits A total of 16 studies involving 346 patients were included in total. The results of meta-analysis showed that： a） com- pared with the control group, the fenofibrate group had the lower serum uric acid level （WMD=48.68, 95%CI 10.02 to 87.34, P〈0.000 01）, lower Ccr （endogenous creatinine clearance） level （WMD=8.88, 95%CI 1.29 to 16.47, P=0.002）, and similar serum creatinine level （WMD=l.78, 95%CI -2.86 to 6.42, P=0.45）; and b） adverse reaction included gastrointestinal discom- forts, skin rashes and transient increase of GPT and transaminase, most of which were mild. Condusion Fenofibrate has good effects. Due to the low quality of the included studies, the exact effectiveness and adverse reaction need to be rigorously verified based on more multi-center, double-blind, randomized controlled trials with large sample size.
出处
《中国循证医学杂志》
CSCD
2013年第11期1361-1366,共6页
Chinese Journal of Evidence-based Medicine
关键词
非诺贝特
尿酸
系统评价
META分析
随机对照试验
半随机对照试验
Fenofibrate
Uric acid
Systematic review
Meta-analysis
Randomized controlled trial
Quasi-rand-omized controlled trial
