他汀类药物对慢性阻塞性肺疾病患者治疗作用的Meta分析

摘要

目的：系统评价他汀类药物对慢性阻塞性肺疾病(COPD)患者的治疗作用。方法计算机检索PubMed、维普(VIP)、万方数据库、中国知网和中国生物医学文献数据库(CBM)中关于他汀类药物对慢性阻塞性肺疾病患者治疗作用的随机对照试验，检索时限为建库至2014年4月。由研究者根据GRADE系统推荐分级方法，对纳入文献进行质量评价，对符合质量标准的文献采用Review Manager 5.1和GRADEprofiler 3.6软件进行Meta分析。结果共纳入12篇研究，Meta分析结果显示：他汀类药物对慢性阻塞性肺疾病患者FEV1%预计值和FEV1/FVC的改善作用与对照组比较差异有统计学意义[WMD=3.30，95%CI (1.25，5.35)，P=0.002；WMD=4.05，95%CI (2.52，5.58)，P<0.00001]；同时与对照组比较，他汀类药物可显著降低慢性阻塞性肺疾病患者C反应蛋白(CRP)水平，差异有统计学意义[WMD=-1.19，95%CI (-1.67，-0.71)，P<0.00001]。结论现有研究显示他汀类药物可显著改善慢性阻塞性肺疾病患者肺功能并降低其全身炎症反应，值得在临床上推广。%Objective To evaluate the effect of statins in the treatment of patients with chronic obstructive pulmonary disease (COPD) systematically. Methods PubMed, Wanfang Data, VIP Data, CNKI and CBM were searched for researches of Randomized controlled trials (RCTs) on statins in the treatment of patients with chronic ob-structive pulmonary disease, with time limited from the databases' establishment dates to April 2014. The included re-searches were evaluated based on the GRADE system, then meta-analysis on the qualified researches were performed by adopting Review Manager 5.1 and GRADE profiler 3.6. Results The meta-analysis of all twelve researches showed that the difference of predicted FEV1% and FEV1/FVC between the two groups was statistically significant [WMD=3.30, 95%CI (1.25, 5.35), P=0.002;WMD=4.05, 95%CI (2.52, 5.58), P<0.000 01];Meanwhile, by comparing with the control group, patients in the treatment group showed an obvious lower C-reactive protein (CRP) level [WMD=-1.19, 95%CI (-1.67,-0.71), P<0.000 01]. Conclusion The current evidence showed that statins can signifi-cantly improve lung function and systemic inflammatory responses in COPD patients, and is thus worthy of application.