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Systematic Review Article

他汀类药物或贝特类药物治疗对同型半胱氨酸浓度的影响:一项系统回顾和荟萃分析

卷 31, 期 14, 2024

发表于: 05 June, 2023

页: [1920 - 1940] 页: 21

弟呕挨: 10.2174/0929867330666230413090416

价格: $65

摘要

介绍：他汀类药物和贝特类药物是两种用于血脂异常患者的降脂药物。本系统综述和荟萃分析旨在确定他汀类药物和贝特治疗对血清同型半胱氨酸水平的影响程度。 方法:检索截至2022年7月15日的PubMed、Scopus、Web of Science、Embase和Google Scholar电子数据库。主要终点集中在血浆同型半胱氨酸水平。酌情使用固定或随机效应模型对数据进行定量分析。根据药物及他汀类药物的亲水-亲脂平衡进行亚组分析。 结果:在筛选了1134篇论文后，52项研究共20651名受试者被纳入meta分析。分析显示，他汀类药物治疗后血浆同型半胱氨酸水平显著降低(WMD: -1.388 μmol/L, 95% CI: [-2.184， -0.592]， p = 0.001;I2 = 95%)。然而，贝特治疗显著提高血浆同型半胱氨酸水平(WMD: 3.459 μmol/L, 95% CI: [2.849, 4.069]， p < 0.001;I2 = 98%)。阿托伐他汀和辛伐他汀的疗效取决于剂量和治疗时间(阿托伐他汀[系数:0.075 [0.0132,0.137];P = 0.017，系数:0.103 [0.004,0.202];P = 0.040]和辛伐他汀[系数:-0.047 [-0.063，-0.031];P < 0.001，系数:0.046 [0.016,0.078];P = 0.004])，而非诺贝特的效果随时间持续(系数:0.007 [-0.011,0.026];P = 0.442)，且不受剂量变化的影响(系数:-0.004 [-0.031,0.024];P = 0.798)。此外，他汀类药物降低同型半胱氨酸的效果越大，基线血浆同型半胱氨酸浓度越高(系数:-0.224 [-0.340，-0.109];P < 0.001)。 结论:贝特类显著提高同型半胱氨酸水平，而他汀类显著降低同型半胱氨酸水平。

关键词: 他汀类、贝特、同型半胱氨酸、动脉粥样硬化、血脂异常、降脂药物。

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