他汀类药物对类风湿关节炎炎症因子影响的Meta分析

摘要

Objective To investigate the effects of statins on inflammation factors in the treatment of patients with rheumatoid arthritis(RA) .Methods Relevant randomized controlled trials (RCTs) were retrieved from the following electronic databases :PubMed(January 1966 to August 2011) ,CENTRAL(Cochrane Controlled trials Register ;issue 3 ,2011) and EMBASE .com(Janu-ary 1984 to August 2011) .Two independent reviewers systematically identified prospective RCTs to detect the effect of statins on inflammation in patients with RA .A Meta-analysis of these clinical trials was then performed .Results 7 RCTs ,enrolling a total of 279 patients .Inflammation level of RA was assessed by erythrocyte sedimentation rate (ESR) and C-reactive protein(CRP) level .St-atins had a positive effect on reducing the CRP [x-0 .58s ,95% CI:(-1 .08 ,-0 .09) ,P=0 .02] ,but did not has a positive effect on reducing the ESR[x-3 .62s ,95% CI:(-12 .15 ,4 .92) ,P=0 .41] level in patients with RA .Conclusion Statins therapy in patients with RA may have a positive effect on reducing the inflammation factors level .And more RCTs would be necessary to further con-firme the effect .%目的：研究他汀类药物对类风湿关节炎（RA ）炎症因子的影响。方法从以下电子数据库中检索相关的随机对照试验：PubMed（1966年1月至2011年8月），CENTRAL（Cochrane Controlled Trials Register ，2011年第3期）和EMBASE（1984年1月至2011年8月）。两个独立的评审系统通过审核随机对照试验，提取、处理数据。确定他汀类药物对RA患者的炎症因子的影响。结果共包括7项对照试验，共279例患者。RA炎症水平由红细胞沉降率（ESR）和C-反应蛋白（CRP）的水平进行评估。他汀类药物使用对降低CRP产生积极影响[均数-0．58×标准差（x-0．58s），95％ CI为（-1．08，-0．09），P＝0．02]，而没有降低ESR水平[x-3．62s ，95％ CI为（-12．15，4．92），P＝0．41]。结论他汀类药物治疗RA对患者炎症因子部分降低具有积极作用。建议进行更多的随机对照试验加以证实。