目的:系统评价他汀类药物对心血管疾病患者肾功能的影响.方法:检索中国知网、EMBase、Medline、维普数据库及万方数据库,按照纳入标准筛选他汀类药物治疗心血管疾病的随机对照试验[观察组采用他汀类药物治疗,对照组采取常规治疗或未应用他汀类药物治疗,文献需含有患者治疗前后肾小球滤过率(eGFR)的数据],检索时限从2011年1月1日至2018年8月1日;提取数据并进行方法学质量评价后,采用Stata 12.0软件进行文献荟萃分析(Meta分析).结果:共纳入12篇文献,均为随机对照试验,各研究间不存在异质性.Meta分析结果显示,观察组患者的治疗前后eGFR变化值明显优于对照组,差异有统计学意义(MD=0.11,95％CI=0.02～0.20,P=0.01);亚组分析结果显示,观察组中长时间(＞6个月)服用他汀类药物患者治疗前后eGFR变化值明显优于对照组,差异有统计学意义(MD=0.12,95％CI=0.01～0.22,P=0.03),但观察组中短期(≤6个月)服用他汀类药物患者治疗前后eGFR变化值与对照组的差异无统计学意义(MD=0.10,95％CI=-0.06～0.26,P=0.21).结论:他汀类药物对心血管疾病患者的肾功能具有一定的保护作用,且此作用在长期服用他汀类药物治疗中更为明显.%OBJECTIVE: To evaluate the effects of statins on renal function in patients with cardiovascular disease. METHODS: CNKI, EMBase, Medline, VIP and Wanfang database were retrieved to collected randomized controlled trials (RCT) of statins for cardiovascular disease according to inclusion criteria [the observation group was treated with statins, the control group received conventional treatment or no statins therapy, literature should include data on glomerular filtration rate (eGFR) before and after treatment] from Jan. 1 st, 2011 to Aug. 1 st, 2018. After data extraction and methodological quality evaluation, meta-analysis (Meta analysis) of the literature was performed using Stata 12.0 software. RESULTS: A total of 12 literature were included, all of which were randomized controlled trials. There was no heterogeneity among the studies. Meta-analysis showed that after treatment, the changes of eGFR before and after treatmen in the observation group was significantly better than that in the control group, and the difference was statistically significant (MD=0.11, 95％CI=0.02-0.20, P=0.01). Subgroup analysis showed that the changes of eGFR before and after treatmen of patients taking statins for a long time (＞6 months) in the observation group was significantly better than that of the control group, the difference was statistically significant (MD=0.12, 95％CI=0.01-0.22, P=0.03), yet there was no significant difference in the changes of eGFR before and after treatmen between patients taking statins for a short term (≤6 months) in the observation group and the control group (MD=0.10, 95％CI=-0.06-0.26, P=0.21). CONCLUSIONS: Statins have a protective effect on renal function in patients with cardiovascular disease, and the effect is more pronounced in long-term statin therapy.
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