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目的:系统评价2型糖尿病患者不同剂量沙格列汀与上呼吸道感染发病的相关性。方法:计算机检索Cochrane Library(2015年第4期)、PubMed(1978-2015.12)、EMbase(1974-2015.12)、CNKI(1978-2015.12)、VIP(1989-2015.12)、CBM(1978-2015.12)、网上图书馆(Elsevier Science-Science Direct,Nature Publishing Group,Oxford University Press,Science,Wiley-Blackwell and Springer Link)建库至2015年12月的所有文献资料。按照Cochrane系统评价方法查找沙格列汀治疗2型糖尿病发生上呼吸道感染的所有随机对照试验(RCT),进行数据提取和质量评价后,采用RevMan 5.3软件进行Meta分析。结果:共纳入12个研究。Meta分析结果显示:不同剂量沙格列汀治疗上呼吸道感染的发病风险与安慰剂组相似,差异无统计学意义[RR=1.12,95%CI(0.86,1.47),P=0.40],其中[2.5 mg·d-1:RR=1.12,95%CI(0.86,1.47),P=0.40;5 mg·d-1:RR=1.04,95%CI(0.86,1.26),P=0.67;10 mg·d-1:RR=1.20,95%CI(0.86,1.67),P=0.29]。而且相同剂量的沙格列汀单药和联合治疗上呼吸道感染的发病风险均与安慰剂组相似,差异亦无统计学意义。结论:不同剂量沙格列汀单药和联合治疗均不增加上呼吸道感染的发病风险。但其远期安全性有待开展更多高质量、大样本、长期随访的RCT加以验证。
Objective: To systematically evaluate the relationship between different doses of saxagliptin and upper respiratory tract infection in type 2 diabetic patients. Methods: Cochrane Library (No.4, 2015), PubMed (1978-2015.12), EMbase (1974-2015.12), CNKI (1978-2015.12), VIP (1989-2015.12), CBM Library (Elsevier Science-Science Direct, Nature Publishing Group, Oxford University Press, Science, Wiley-Blackwell and Springer Link) All archives through December 2015. All randomized controlled trials (RCTs) of Saxagliptin for the treatment of upper respiratory infections in type 2 diabetes were performed according to the Cochrane systematic review. After data extraction and quality evaluation, Meta-analysis was performed using RevMan 5.3 software. Results: A total of 12 studies were included. Meta-analysis showed that the incidence of upper respiratory tract infection with different doses of saxagliptin was similar to that of placebo, with no significant difference (RR = 1.12, 95% CI 0.86, 1.47, P = 0.40) 2.5 mg · d -1: RR = 1.12 95% CI 0.86,1.47 P = 0.40 5 mg · d -1 RR = 1.04 95% CI 0.86,1.26 P = 0.67 10 mg · D-1: RR = 1.20, 95% CI (0.86, 1.67), P = 0.29]. And the same dose of saxagliptin monotherapy and combined treatment of upper respiratory tract infection risk were similar to the placebo group, the difference was not statistically significant. Conclusion: Saxagliptin alone and combination therapy did not increase the risk of upper respiratory tract infection. However, its long-term safety needs to be verified by more high-quality, large-scale, long-term follow-up RCTs.