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羟苯磺酸钙治疗早期糖尿病肾病有效性的系统评价
Efficacy of Calcium Dobesilate for Early Diabetic Nephropathy:a Systematic Review
【摘要】 目的系统评价羟苯磺酸钙对早期糖尿病肾病的影响。方法用计算机检索"PubMed、EMBASE、MELINE CNKI"等数据库,检索时间从建库至2018年3月。纳入有关羟苯磺酸钙对早期糖尿病肾病疗效的随机对照试验,由两名评价员独立对纳入研究进行数据提取和质量评价,用RevMan 5.0软件进行Meta分析。结果共11项随机对照试验,共计872例患者。Meta分析结果示:与对照组比较,羟苯磺酸钙治疗早期糖尿病肾病(试验组),可降低胱抑素C(Cys-C)[8周:MD=-0.39(P<0.000 01)、12周:MD=-0.26(P<0.000 01)]、内皮素(ET)[MD=-12.07(P<0.000 1)]和尿蛋白排泄率(UAER)[MD=-23.60(P<0.000 01)],但对血肌酐(Scr)、空腹血糖(FBG)、糖化血红蛋白(HbA1c)的影响无明显差异。结论羟苯磺酸钙可降低早期糖尿病肾病患者的Cys-C、ET和UAER,对早期糖尿病肾病有一定的疗效,但因缺乏高质量的随机对照试验证据支持,故治疗效果还不能做出最后结论,需要更多高质量的随机对照试验才能得出肯定结论。
【Abstract】 Objective To systematically evaluate the effect of calcium dobesilate on early diabetic nephropathy.Methods The PubMed,EMBASE.MEDLINE and CNKI were searched up to March 2018 for randomized controlled trials(RCTs) on the treatment of early diabetic nephropathy with calcium dobesilate.Two investigators extracted data and performed quality analysis independently.RevMan 5.0 software was used for Meta-analysis.Results A total of 11 RCTs with 872 patients were identified.Meta-analysis indicated that calcium dobesilate caused a reduction in cystatin-C(Cys-C) levels(8 weeks,MD=-0.39(P<0.000 01);12 weeks,MD=-0.26(P<0.000 01)),endothelin(ET) concentrations(MD=-12.07,P<0.000 1) and urine albumin excretion rate(UAER)(MD=-23.60,P<0.000 01),but failed to influence serum creatinine(Scr),fasting blood glucose(FBG) and glycosylated hemoglobin(HbA1 c) levels.Conclusion Calcium dobesilate can reduce Cys-C,ET and UAER in patients with early diabetic nephropathy,suggesting that calcium dobesilate is effective for early diabetic nephropathy.However,the conclusion about the effect of calcium dobesilate on early diabetic nephropathy is not reliable currently due to the low-quality evidence.Therefore,more high-quality RCTs are needed to make a definite conclusion.
【Key words】 diabetic nephropathy,early; calcium dobesilate; randomized controlled trials; meta-analysis;
- 【文献出处】 南昌大学学报(医学版) ,Journal of Nanchang University(Medical Sciences) , 编辑部邮箱 ,2019年01期
- 【分类号】R587.2;R692.9
- 【被引频次】3
- 【下载频次】120