苯磺酸左旋氨氯地平对比其他降压药物治疗高血压合并糖尿病的效果及安全的Meta分析-现代医学

苯磺酸左旋氨氯地平对比其他降压药物治疗高血压合并糖尿病的效果及安全的Meta分析

单位：1. 绵阳市中心医院药学部, 四川绵阳 621000;
2. 西南医科大学附属医院药学部, 四川泸州 646000;
3. 成都医学院药学院, 四川成都 610500;
4. 西南医科大学药学院, 四川泸州 646000

分类号：R972

出版年·卷·期（页码）：2020·48·第十二期（1519-1525）

摘要：

目的： 采用Meta分析方法评价苯磺酸左旋氨氯地平与其他降压药物治疗高血压合并糖尿病的有效性和安全性。方法： 计算机检索PubMed、OVID、Embase、Cochrane Library、中国知网、万方、维普数据库，筛选并纳入苯磺酸左旋氨氯地平与其他降血压药物对比治疗高血压合并糖尿病的随机对照试验、病例对照研究或队列研究。采用RevMan 5.3统计软件进行Meta分析。结果： 通过计算机检索相关数据库并筛选后，一共纳入9篇文献，总计963例患者。Meta分析结果显示：（1）与其他降压药物比较，苯磺酸左旋氨氯地平能降低患者的收缩压[加权平均差（WMD）=-1.38，95%CI为-2.64~-0.12，P=0.03，I²=30]；且在降低患者舒张压方面优于其他降压药物（WMD=0.97，95%CI为0.24~1.70，P=0.009，I²=49）；（2）苯磺酸左旋氨氯地平与其他降压药物在降低患者的空腹血糖（WMD=0.41，95%CI为-0.35~1.16，P=0.30，I²=93）和糖化血红蛋白（WMD=0.14，95%CI为-0.07~0.35，P=0.20，I²=33）比较差异无统计学意义；（3）苯磺酸左旋氨氯地平在降低血尿氮素上与其他降压药物差异无统计学意义，但能显著降低患者的血肌酐（WMD=-4.83，95%CI为-6.09~-3.57，P<0.01，I²=0）；（4）苯磺酸左旋氨氯地平与其他降压药物在不良反应发生情况方面，差异无统计学意义。结论： 苯磺酸左旋氨氯地平能降低高血压合并糖尿病患者的收缩压，且降低舒张压方面优于其他降压药物，在降低患者空腹血糖及糖化血红蛋白上差异无统计学意义。但本研究缺乏更高质量的文献证据，还需进一步开展更高质量、大样本的随机对照试验评价该药的有效性及安全性。

Objective: To evaluate the efficacy and safety of levamlodipine besylate versus other antihypertensive drugs in hypertension with diabetes mellitus byMeta analysis.Methods: We collected the articles which reported the clinical treatment effect of levamlodipine besylate versus other antihypertensive drugs in hypertension with diabetes mellitus via searching PubMed, OVID, Embase, Cochrane Library, CNKI, Wanfang, VIP database. And RevMan 5.3 software was used to perform the meta analysis.Results: A total of 9 articles including 963 patients were involved. Meta analysis showed that:(1)Compared with other antihypertensive drugs, levamlodipine besylate can reduced the systolic blood pressure of patients[WMD=-1.38, 95% CI(-2.64,-0.12), P=0.03, I²=30], and the efficacy of reducing patients' diastolic blood pressure[WMD=0.97, 95% CI(0.24, 1.70), P=0.009, I²=49] was better than other antihypertensive drugs; (2) There was no statistical difference between levoamlodipine besylate and other antihypertensive drugs in reducing patients' fasting blood glucose[WMD=0.41,95% CI(-0.35,1.16), P=0.30, I²=93] and glycosylated hemoglobin[WMD=0.14,95% CI(-0.07,0.35), P=0.20,I²=33]; (3) Levoamlodipine besylate was similar to other antihypertensive drugs in reducing blood urea nitrogen, but it can significantly reduced the serum creatinine[WMD=-4.83, 95% CI(-6.09,-3.57), P<0.01, I²=0]; (4) There were no statistically significant differences between levoamlodipine besylate and other antihypertensive drugs in the incidence of adverse reactions.Conclusion: Levamlodipine besylate can reduce systolic blood pressure in patients with hypertension and diabetes mellitus, and is superior to other antihypertensive drugs in reducing diastolic blood pressure. There are no statistical differences between the two groups in reducing fasting blood glucose and glycosylated hemoglobin. However, due to the lack of high-quality literatures in this study, it is necessary to carry out further high-quality, large sample randomized controlled trials to evaluate the efficacy and safety of this drug.

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