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目的:系统评价辛伐他汀早期应用对不稳定型心绞痛的临床疗效及对患者血脂的影响。方法:检索《中国期刊全文数据库》1979—2008年相关文献,尽可能全面收集相关临床试验资料,在严格质量评价的基础上,利用RevMan5.0进行Meta分析;用Peto法对其结果进行检验,以证实其是否具有同质性,然后选择固定效应模型;效应尺度用机会比(odds ratio,OR)和95%可信区间(confidence interval,CI)表示;用漏斗图分析发表性偏倚;疗效判断采用有效和无效两种。结果:7个对辛伐他汀早期应用治疗不稳定型心绞痛的疗效分析研究具有同质性,OR合并值等于5.27,95%可信区间为3.24～8.58。研究显示辛伐他汀能显著降低血清中TC、TG LDL-C浓度,升高HDL-C浓度并明显减少心血管事件的发生率。漏斗图分析显示发表偏倚在可接受范围。结论:可初步认为,早期应用辛伐他汀对不稳定型心绞痛有较好疗效,且显著降低心血管事件的发生。
OBJECTIVE: To systematically evaluate the clinical effect of simvastatin on unstable angina pectoris and its effect on serum lipids in patients with unstable angina pectoris. Methods: The related articles of “Chinese Journal Full-text Database” from 1979 to 2008 were searched and the relevant clinical trial data were collected as comprehensively as possible. Meta-analysis was performed by RevMan 5.0 on the basis of strict quality evaluation. The results were tested by Peto method, To determine if they are homogenous, and then select a fixed-effect model; effect scales are expressed as odds ratio (OR) and 95% confidence interval (CI); funnel plot analyzes for published bias; Use two kinds of effective and invalid. Results: Seven trials of simvastatin on early-stage treatment of unstable angina pectoris had homogeneity, with an OR of 5.27 and a 95% confidence interval of 3.24 to 8.58. Studies have shown that simvastatin can significantly reduce serum TC, TG LDL-C concentration, increased HDL-C concentration and significantly reduce the incidence of cardiovascular events. Funnel plot analysis showed publication bias was within acceptable range. Conclusion: It is initially believed that early application of simvastatin has a good effect on unstable angina and significantly reduces the incidence of cardiovascular events.