中国全科医学2013，Vol.16Issue(8)：904-910,7.DOI:10.3969/j.issn.1007-9572.2013.03.059
抗高血压类药物治疗IgA肾病的Meta分析
Meta-analysis of Antihypertensive Agents in the Treatment of IgA Nephropathy
摘要
Abstract
Objective To evaluate the efficacy and safety of antihypertensive agents in the treatment of IgA nephropathy. Methods We searched the Cochrane library, PubMed, EMBase, CBMdisc, CNKI, VIP for related articles published from the establishment of the database to 31 May 2012. Three reviewers assessed the quality of the searched studies and extracted data. RevMan 5. 0 was used to conduct meta - analysis on homogenous studies. Results Twenty - three studies involving 1 504 participants were included. Incidence of end stage renal disease ( ESRD ) /doubled serum creatinine [ OR = 0. 20, 95% CI ( 0. 08, 0. 51 )] and 24 - hour proteinuria [ MD = - 0. 77, 95% CI ( - 1. 04, - 0. 49 ) ] were significantly different between angiotensin - converting enzyme inhibitor ( ACEI ) / angiotensin Ⅱ receptor blocker ( ARB ) groups and placebo/no treatment groups (P<0. 05 ). 24 -hour proteinuria [ MD = -0.50, 95% CI ( -0.70, - 0. 31 )] of ACEI + ARB group was significantly different from ARB or ACEI group ( P <0. 05 ). ESRD [ OR =2. 01, 95% CI ( 1. 02, 3. 95 ) ] was significantly different between ACEI and ARB group ( P <0. 05 ). Serum creatinine level [ MD = - 39. 37, 95% CI ( - 71. 95, - 6. 80 ) ], 24 -hour proteinuria I MD = - 1. 16, 95% CI ( - 1. 52, - 0. 81 ) ], and creatinine clearance [ MD = 19. 10, 95% CI ( 10. 44, 27. 77 )] were significantly different between ACEI/ARB/ACEI + ARB group and symptomatic treatment group ( P <0. 05 ). 24 - hour proteinuria [ MD = - 0. 20, 95 % C/ ( - 0. 26, - 0. 14)] was significantly different between ARB + glucocorticoid group and glucocorticoid group ( P < 0. 05 ). 24 - hour proteinuria [ MD = - 0. 54, 95% CI ( - 0. 83 , - 0. 25 ) ] was also significantly different between ACEI + β - blocker group and calcium - channel blocker + β - blocker group ( P < 0. 05 ). Conclusion Both ACEI and ARB can reduce proteinuria in patients with IgA nephropathy, and the combination of the two drugs has better effects. The therapeutic effect of ARB is at least no inferior to ACEI. It can not be concluded whether antihypertensive agents can improve the renal function and prognosis of patients with IgA nephropathy.关键词
IgA肾病/血管紧张素转换酶抑制药/血管紧张素Ⅱ受体拮抗剂/β-受体阻滞剂/钙离子拮抗剂/治疗结果/随机对照试验/Meta分析Key words
IgA nephropathy/ Angiotensin - converting enzyme inhibitors/ Angiotensin Ⅱ receptor antagonist / β -blocker/ Calcium - channel blockers/ Treatment outcome / Randomized controlled trials / Meta - analysis分类
医药卫生引用本文复制引用
沈琪,欧阳小林,黄献文,杨彤,黄贤贵,朱玉宸..抗高血压类药物治疗IgA肾病的Meta分析[J].中国全科医学,2013,16(8):904-910,7.基金项目
广西壮族自治区卫生厅自筹课题(Z2012567) （Z2012567）
