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目的对补充维生素E预防心肌梗死的效果进行Meta分析。方法在Web of science、Pub Med、Embase数据库检索所有相关的临床随机对照试验研究文献,同时追索文献的参考文献,检索起止时间为建库时间至2015年5月。2名研究者严格按照纳入标准和排除标准对检索到的文献进行筛选,并进行文献质量评价,提取有效数据,应用Meta分析方法对符合标准的各个研究进行分析及数据合并。采用Review Manager 5.0软件进行数据分析。结果共纳入文献5篇,包括87 296例人群(其中试验组43 647例,对照组43 649例),由方法学质量评价得出,各研究间基线相似,Jadad评分显示均为高质量研究。Meta分析结果显示,各研究间具有异质性(P=0.02,Ι2=65%),采用随机效应模型进行效应量合并,补充维生素E与安慰剂比较,心肌梗死发病率差异无统计学意义[RR=0.94,95%CI(0.82,1.08),P=0.39]。敏感性分析结果显示,合并效应量分别为RR=1.01,95%CI(0.94,1.08),P=0.74;RR=0.97,95%CI(0.86,1.09),P=0.58;RR=0.91,95%CI(0.76,1.09),P=0.31;RR=0.88,95%CI(0.73,1.07),P=0.19;RR=0.90,95%CI(0.72,1.12),P=0.34,剔除任意一项研究后对Meta分析结果没有逆转作用。漏斗图分析结果显示,研究的发表偏倚较小,结果可信。结论 Meta分析结果提示,尚无证据认为补充维生素E能预防心肌梗死发生。
Objective To analyze the effect of vitamin E supplementation on prevention of myocardial infarction. Methods All relevant literatures of clinical randomized controlled trials were searched in Web of Science, PubMed and Embase databases. At the same time, literature references were retrieved. The starting and ending dates of retrieval were from May 2015 to May 2015. Two researchers screened the retrieved documents strictly according to the inclusion criteria and exclusion criteria, evaluated the quality of the literature, extracted valid data, and analyzed and analyzed the data according to the standard by Meta analysis. Review Manager 5.0 software for data analysis. Results A total of 5 articles were included in the literature, including 87 296 people (43 647 in the trial group and 43 649 in the control group). Methodological quality evaluations showed similar baseline among all the studies. Jadad scores showed high quality. Meta-analysis showed heterogeneity between the studies (P = .02, Ι2 = 65%). Random effects models were used for the combination of effects. There was no significant difference in the incidence of MI between vitamin E supplementation and placebo [ RR = 0.94, 95% CI (0.82, 1.08), P = 0.39]. Sensitivity analysis showed that the combined effects were RR = 1.01,95% CI (0.94,1.08), P = 0.74; RR = 0.97,95% CI (0.86,1.09), P = 0.58; RR = 0.91,95 RR = 0.88, 95% CI (0.73, 1.07), P = 0.19; RR = 0.90, 95% CI (0.72, 1.12), P = 0.34, Meta analysis results did not reverse the study after the study. Funnel chart analysis results show that the publication of the study bias is small, the result is credible. Conclusions Meta analysis suggested that there is no evidence that vitamin E supplementation can prevent myocardial infarction.