西尼地平与L-型钙离子通道阻滞剂对高血压患者肾脏功能影响的meta分析

doi:10.5246/jcps.2015.11.095

中国药学(英文版) ›› 2015, Vol. 24 ›› Issue (11): 744-753.DOI: 10.5246/jcps.2015.11.095

西尼地平与L-型钙离子通道阻滞剂对高血压患者肾脏功能影响的meta分析

叶晓春¹, 董志^2*, 赵春景³, 李頔³, 钱妍³

1. 重庆市第十三人民医院药剂科, 重庆 400053
2. 重庆市生物化学与分子药理学重点实验室, 重庆 400016
3. 重庆医科大学附属第二医院药学部, 重庆 400010

收稿日期:2015-05-17 修回日期:2015-07-17 出版日期:2015-11-20 发布日期:2015-07-29
通讯作者: Tel.: 86-23-63631918, E-mail: zhidong073@hotmail.com
基金资助:
Chongqing Municipal Commission of Health and Family Planning (Grant No. 2015ZBXM005).

Effects of cilnidipine and L-type calcium channel blockers on renal functions in hypertensive patients: a meta-analysis of the randomized trials

Xiaochun Ye¹, Zhi Dong^2*, Chunjing Zhao³, Di Li³, Yan Qian³

1. Department of Pharmacy, the Thirteenth People's Hospital of Chongqing, Chongqing 400053, China
2. Chongqing Key Laboratory for Biochemistry and Molecular Pharmacology, Chongqing 400016, China
3. Department of Pharmacy, the Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China

Received:2015-05-17 Revised:2015-07-17 Online:2015-11-20 Published:2015-07-29
Contact: Tel.: 86-23-63631918, E-mail: zhidong073@hotmail.com
Supported by:
Chongqing Municipal Commission of Health and Family Planning (Grant No. 2015ZBXM005).

摘要/Abstract

摘要：

本文综合评价西尼地平和L-型钙通道阻滞剂(L-型CCB)对高血压患者肾脏功能的影响。我们采用了检索Pubmed、Embase、Google Scholar、CNKI、Science Direct、Ebsco、Springer、Ovid、Cochrane Library、Medline、维普和万方等数据库建库至2014年9月有关西尼地平和L-型CCB对肾脏功能影响的临床随机对照试验(RCT)文献。按Jadad质量标准对纳入文献进行独立评价并交叉核对, 采用RevMan 5.3软件进行Meta分析。以血清肌酐值(SCr)、尿蛋白排泄量(UPE)、尿蛋白/肌酐比(UPCR)、估算的肾小球滤过率(eGFR)为指标, 以用药前后指标变化百分率均数差值(mean difference, MD)及其95%可信区间(95% CI)进行综合评价。发现共纳入10篇质量较高RCT文献, 采用随机效应或固定效应模型分析, 结果显示: 治疗后, 西尼地平组较L-型CCB组更明显降低UPE, 二者对UPE影响有显著区别(MD = –36.59, 95% CI: –70.85, –2.33),西尼地平组较L-型CCB组更明显降低UPCR, 二者对UPCR影响有显著区别(MD = –46.56, 95% CI: –88.50, –4.62); 而对SCr(MD = 0.01, 95% CI: –2.97, 2.98)及eGFR (MD = 1.56, 95% CI: –0.19, 3.31)的影响二组间无显著差异。由此可知, 与L-型CCB相比, 西尼地平更能有效减少尿蛋白的排泄, 延缓蛋白尿发展进程, 而对SCr及eGFR影响方面, 二组间无明显差异。

关键词: 西尼地平, L-型钙通道阻滞剂, 肾脏功能, Meta分析, 随机对照试验

Abstract:

In the present study, we aimed to evaluate the effects of cilnidipine and L-type calcium channel blockers (L-type CCBs) on renal function in hypertensive patients. The randomized controlled trials (RCTs) of cilnidipine and L-type CCBs on hypertension treatment were selected from Pubmed, Embase, Google Scholar, CNKI, Science Direct, Ebsco, Springer, Ovid, Cochrane Library, Medline, VIP and Wanfang databases (from the date of databases’ establishment to September 2014). Data were independently evaluated following the Jadad standard. The percentage changes of serum creatinine (SCr) value, urinary protein excretion (UPE), urinary protein/creatinine ratio (UPCR) and estimated glomerular filtration rate (eGFR) pre- and post-treatment were extracted for the subsequent meta-analysis. The mean difference (MD) and the 95% confidence interval (95% CI) were determined using RevMan 5.3 software.A total of 10 RCTs of high quality were included and analyzed by fixed- or random-effect models. The results indicated that UPE (MD = –36.59, 95% CI: –70.85, –2.33) or UPCR (MD = –46.56, 95% CI: –88.50, –4.62) was significantly reduced by cilnidipine compared with L-type CCBs. However, such significant difference was not detected in reduction of SCr (MD = 0.01, 95% CI: –2.97, 2.98) or eGFR (MD = 1.56, 95% CI: –0.19, 3.31). Compared with L-type CCBs, cilnidipine was more effective in reducing proteinuria or preventing the proteinuria progression. In addition, we did not find significant differences in SCr and eGFR between the two groups.

Key words: Cilnidipine, L-type CCBs, Renal function, Meta-analysis, Randomized controlled trial

中图分类号:

R962.1

Supporting:

叶晓春, 董志, 赵春景, 李頔, 钱妍. 西尼地平与L-型钙离子通道阻滞剂对高血压患者肾脏功能影响的meta分析[J]. 中国药学(英文版), 2015, 24(11): 744-753.

Xiaochun Ye, Zhi Dong, Chunjing Zhao, Di Li, Yan Qian. Effects of cilnidipine and L-type calcium channel blockers on renal functions in hypertensive patients: a meta-analysis of the randomized trials[J]. Journal of Chinese Pharmaceutical Sciences, 2015, 24(11): 744-753.

参考文献

[1] Fu, Q.; Levine, B.D. Hypertension. 2006, 3, 323-324.
[2] Ewen, S.; Ukena, C.; Linz, D.; Schmieder, R.E.; Bohm, M.; Mahfoud, F. Curr. Hypertens Rep. 2013, 15, 370-376.

[3] Hausberg, M.; Kosch, M.; Harmelink, P.; Barenbrock, M.; Hohage, H.; Kisters, K.; Dietl, K.H.; Rahn, K.H. Circulation.2002, 106, 1974-1979.

[4] James, P.A. 2014, 311, 507-520. This article can be found online at http://jama.jamanetwork.com/on 02/02/2014/JAMA. doi:10.1001/jama.2013.284427JAMA.

[5] Uneyama, H.; Takahara, A.; Dohmoto, H.; Yoshimoto, R.; Inoue, K.; Akaike, N. Brit. J. Pharmacol. 1997, 122, 37-42.

[6] Hirning, L.D.; Fox, A.P.; McCleskey, E.W.; Oliver, B.M.; Thayer, S.A.; Miller, R.J.; Tsien, R.W. Science. 1988, 239, 57-61.

[7] Murakami, M.; Ohba, T.; Xu, F.; Sstoh, E.; Miyoshi, L.; Suzuki, T.; Takahashi, Y.; Takahashi, E.; Watanaba, H.; Ono, K.; Sasano, H.; Kasai, N.; lto, H.; lijima, T. J. Biol. Chem. 2008, 283, 24554-24560.

[8] Fujii, S.; Kameyama, K.; Hosono, M.; Hayashi, Y.; Kitamura, K. Pharmacol. Exp. Ther. 1997, 280, 1184-1191.

[9] Salomonsson, M.; Brannstrom, K.; Arendshorst, W.J. Am. J. Physiol-Renal. Physiol. 2000, 278, F138-F147.

[10] Alexander, N.; Marie, J.M.; Jippe, C.B.; Martin, P.; Pieter, A.V.Z. Fundam. Clin. Pharmacol. 2004, 18, 309-319.

[11] Malleshappa, P. Dial. Traspl. 2013, 34, 2-6.

[12] Jadad, A.R.; Moore, R.A.; Carroll, D.; Jenkinson, C.; Reynolds, D.J.; Gavaqhan, D.J.; McQuay, H.J. Control. Clin. Trials. 1996, 17, 1-12.

[13] Higgins, J.P. Deeks, J.J. Altman, D.G. editors. Chapter 16: special topics in statistics. In Higgins JP, Green S, editors. Cochrane handbook for systematic reviews of interventions. Version 5.3. The Cochrane Collaboration, 2014. Available from www.cochrane-handbook.org

[14] Follmann, D.; Elliott, P.; Suh, I.; Cutler, J. Clin. Epidemiol. 1992, 45, 769-773.

[15] Takagi, H.; Yamamoto, H.; Iwata, K.; Goto, S.N.; Umemoto, T. Int. J. Cardiol. 2013, 167, 1443-1449.

[16] Ando, K.; Ueshima, K.; Tanaka, S.; Kosuqi, S.; Sato, T.; Matsuoka, H.; Nakao, K.; Fujita, T. Int. J. Med. Sci. 2013, 10, 1209-1216.

[17] Abe, M.; Maruyama, N.; Suzuki, H.; lnoshita, A.; Yoshida, Y.; Okada, K.; Soma, M. Heart Vessels. 2013, 28, 480-489.

[18] Kojima, S., Shida, M., Yokoyama, H. Hypertens Res. 2004, 27, 379-385.

[19] Fujita, T.; Ando, K.; Nishimura, H.; ldeura T.; Yasuda, G.; lsshiki, M.; Takahashi, K. Kidney Int. 2007, 72, 1543-1549.

[20] Konoshita, T.; Makino, Y.; Kimura, T.; Fujii, M.; Wakahara, S.; Arakawa, K.; lnoki, l.; Nakamura, H.; Miyamori, I. J. Hypertens. 2010, 28, 2156-2160.

[21] Kanaoka, T.; Tamura, K.; Wakui, H.; Ohsawa, M.; Azushima, K.; Uneda, K.; Kobayashi, R.; Fujikawa, T.; Tsurumi-Ikeya, Y.; Maeda, A.; Yanaqi, M.; Toya, Y.; Umemura, S. Int. J. Mol. Sci. 2013, 14, 16866-16881.

[22] Satomura, A.; Fujita, T.; Fuke, Y.; Wada, Y.; Matsumoto, K. Open Clin. Chem. J. 2009, 2, 31-36.

[23] Miwa, Y.; Tsuchihash, T.; Ohta, Y.;Tominaga M.; Kawano, Y.; Sasaguri, T.; Ueno, M.; Matsuoka, H. Clin. Exp. Hypertens.2010, 32, 400-405.

[24] Cao, B.Q.; Liu, D.Y.; Wang, S.Z.; Fan, Y.G. China Med. 2010, 5, 494-496.

[25] Morimoto, S.; Yanoa, Y.; Maki, K.; Iwasaka, T.J. Hypertens. 2007, 25, 2178-2183.

[26] Iseki, K.; Ikemiya, Y.; Iseki, C.; Takishita, S. Kidney Int. 2003, 63, 1468-1474.

[27] Brenner, B.M.; Cooper, M.E.; de Zeeuw, D.; Keane, W.F.; Mitch, W.E.; Parving, H.H.; Remuzzi, G.; Snapinn, S.M.; Zhang, Z.; Shahinfar, S. N. Engl. J. Med. 2001, 345, 861-869.
[28] Peterson, J.C.; Adler, S.; Burkart, J.M.; Greene, T.; Hebert, L.A.; Hunsicker, L.G.; King, A.J.; Klahr, S Massry, S.G.; Seifter, J.L. Ann. Intern. Med. 1995, 123, 754-762.

西尼地平与L-型钙离子通道阻滞剂对高血压患者肾脏功能影响的meta分析

Effects of cilnidipine and L-type calcium channel blockers on renal functions in hypertensive patients: a meta-analysis of the randomized trials

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