【摘要】：目的:他汀類藥物是否增加白內(nèi)障的發(fā)生率一直以來都沒有定論,各個研究之間得出的結(jié)論也都不一致,本研究旨在通過對現(xiàn)有已經(jīng)發(fā)表的隨機(jī)對照研究進(jìn)行薈萃分析,客觀評價使用他汀類藥物后與白內(nèi)障發(fā)生率的關(guān)系,為患者及臨床醫(yī)生更全面的了解他汀與白內(nèi)障關(guān)系提供參考。方法:檢索Pubmed,Embase,Cochrane協(xié)作網(wǎng)和Web of Science,按照納入標(biāo)準(zhǔn)和排除標(biāo)準(zhǔn)對2017年1月前有關(guān)他汀類藥物與白內(nèi)障發(fā)生率的研究進(jìn)行篩選,記錄入選的研究他汀組及對照組(安慰劑組)新發(fā)白內(nèi)障或行白內(nèi)障手術(shù)的人數(shù)。使用RevMan5.3統(tǒng)計(jì)軟件做薈萃分析。結(jié)果:共納入6個隨機(jī)對照研究,合計(jì)26534例患者,其中15417例患者接受他汀治療,11117例患者接受安慰劑治療,隨訪時間至少12個月。對納入的6項(xiàng)研究進(jìn)行薈萃分析,隨訪期間,他汀組與對照組相比,兩組間白內(nèi)障發(fā)生率未見顯著性差異(RR:0.93,95%CI:0.75-1.14,P=0.46)。由于各個研究入選人群存在差異,剔除其中一項(xiàng)多中心,包含多個國家的人群的研究,進(jìn)行亞組分析,發(fā)現(xiàn)他汀的使用可降低歐美人群白內(nèi)障的風(fēng)險(xiǎn)(RR=0.83;95%CI:0.71-0.98,P=0.03)。對終點(diǎn)事件為臨床白內(nèi)障的5個研究進(jìn)行分析,發(fā)現(xiàn)兩組間白內(nèi)障發(fā)生率無顯著性差異(RR:0.94,95%CI:0.73-1.21,P=0.64)。結(jié)論:本研究結(jié)果表明,在總?cè)巳褐?應(yīng)用他汀類藥物不會影響白內(nèi)障的發(fā)生率。他汀對晶狀體的作用在不同的人群中可能存在差異,在歐美人群中,他汀的使用可能降低白內(nèi)障的發(fā)生率。只對終點(diǎn)事件為臨床白內(nèi)障的5項(xiàng)研究進(jìn)行分析表明,他汀類藥物不會增加患者臨床白內(nèi)障的發(fā)生率。
[Abstract]:Objective: whether statins increase the incidence of cataracts has been inconclusive and inconsistent across studies. The aim of this study was to conduct a meta-analysis of published randomized controlled studies. Objective evaluation of the relationship between statins and the incidence of cataract, for patients and clinicians a more comprehensive understanding of the relationship between statins and cataract. Methods: Pubmed,Embase,Cochrane collaboration and Web of Science, were searched for screening of statins and cataract incidence by January 2017 according to inclusion criteria and exclusion criteria. Record the number of new cataract or cataract operations in the statins group and control group (placebo group). Use RevMan5.3 statistical software to do meta-analysis. Results: a total of 26534 patients were enrolled in 6 randomized controlled trials, of which 15417 received statins and 11117 received placebo for at least 12 months. There was no significant difference in cataract incidence (RR:0.93,95%CI:0.75-1.14,P=0.46) between the statins group and the control group during the follow-up period. Because of the differences in the selected population, one of the multicenter studies including multiple countries was excluded and the subgroup analysis showed that the use of statins could reduce the risk of cataract (RR=0.83;95%CI:0.71-0.98,P=0.03) in the European and American population. There was no significant difference in the incidence of cataract between the two groups (RR:0.94,95%CI:0.73-1.21,P=0.64). Conclusion: the results of this study suggest that statins do not affect the incidence of cataract in the general population. The effects of statins on the lens may vary from population to population. In Europe and the United States, the use of statins may reduce the incidence of cataract. An analysis of only 5 studies in which the endpoint event was clinical cataract showed that statins did not increase the incidence of clinical cataract.
【學(xué)位授予單位】：浙江大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R776.1
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本文編號：2269223