【摘要】 目的评价依普利酮治疗原发性高血压的临床疗效与安全性。方法按纳入标准,电子检索Cochrane图书馆最近一期出版的Cochrane对照试验注册数据库,PubMed,MEDLINE,EMBASE,CINAHL,OVID,Medscape,TRIP,CBM,NRR;手工检索发表或未发表的文献。文献资料用统一的表格由两名评价者独立提取,对文献质量进行评价,并用RevMan4.2.7软件对数据进行Meta分析。结果共检索到随机对照试验9篇,经排查后,符合纳入标准并进入系统评价的文献共4篇,均为较高质量随机对照试验。Meta分析结果显示:依普利酮与安慰剂比较,诊室收缩压变化WMD=-9.23,95%CI-10.20～-8.26,P<0.00001;诊室舒张压变化WMD=-4.22,95%CI-4.90～-3.54,P<0.00001;总副作用发生率OR=0.91,95%CI0.53～1.56,P=0.74。结论依普利酮降压是有效、安全的,其长期疗效、对不同亚组患者作用的差别及其安全性等仍需进行更多高质量的随机对照试验才能得出肯定性结论。更多还原

【Abstract】 Objective To assess the efficacy and safety of Eplerenone for essential hypertension. Methods Included studies were randomized controlled trials of Eplerenone versus placebo. Electronic search was applied to CENTRAL,published in the latest issue of the Cochrane Library, PubMed, MEDLINE, EMBASE, CINAHL, OVID, Medscape, TRIP, CBM, NRR. Hand searches published and unpublished papers. Two independent reviewers extracted data. Trials were assessed for quality. RevMan4.2.7 software developed by the Cochrane Collaboration was used for meta-analysis. Results Nine related articles were identified, but only four with patients who were eligible and were included in the systematic review. All articles were of high quality, from developed countries. Eplerenone compared with placebo for clinic systolic BP, WMD=-9.23, 95%CI -10.20～-8.26, P < 0.000 01; for clinic diastolic BP, WMD=-4.22, 95%CI -4.90～ -3.54, P < 0.000 01; for totle adverse events, OR=0.91, 95%CI 0.53～1.56, P=0.74. Conclusions Based on the review, Eplerenone is well effective and tolerated in reducing BP. Further large randomized, double blind, placebo-controlled trials are needed in long-term safety and efficacy and different subgroups of Eplerenone.更多还原