Zhongguo cuzhong zazhi (Mar 2024)
普罗布考联合他汀类药物治疗颈动脉斑块的meta分析 The Effect of Probucol Combined with Statins in the Treatment of Carotid Plaque: A Meta-Analysis
Abstract
目的 探究普罗布考联合他汀类药物治疗颈动脉斑块的疗效。 方法 以“普罗布考”“他汀”“颈动脉”为中文关键词，检索中文数据库中国知网、维普网、万方数据库，以“carotid artery”“probucol”“statins”为英文关键词，检索英文数据库PubMed、Cochrane Library、Embase，筛选普罗布考联合他汀类药物治疗颈动脉斑块的随机对照试验。检索时间为数据库建立至2023年12月17日。以单用他汀类药物治疗为对照组，他汀类药物联合普罗布考治疗为联合治疗组。参照Cochrane偏倚风险评估对纳入的研究进行质量评价。主要结局指标包括颈动脉内-中膜厚度 （intima-media thickness，IMT），次要结局指标包括TC水平、hs-CRP水平、卒中事件发生等。采用RevMan 5.1软件进行meta分析。 结果 最终纳入11项随机对照试验，共纳入3251例患者。meta分析显示，在降低IMT方面，联合治疗组优于对照组[标准化均数差（standardized mean difference，SMD）-0.93，95%CI -1.66～-0.20，P＜0.001]； 在降低TC水平方面，联合治疗组优于对照组（SMD -1.08，95%CI -1.60～-0.55，P＜0.001）；在降低hs-CRP水平方面，两组差异无统计学意义（SMD -1.22，95%CI -2.48～0.04，P=0.060）；在减少卒中事件发生方面，联合治疗组优于对照组（RR 0.34，95%CI 0.17～0.65，P=0.001）。 结论 普罗布考联合他汀类药物治疗颈动脉斑块疗效更优，可降低患者的TC水平，并减少卒中事件发生。 Abstract: Objective To investigate the efficacy of probucol combined with statins in the treatment of carotid plaque. Methods Using “probucol” “statin” “carotid artery” as the keywords, Chinese databases CNKI, VIP and WanFang, English databases PubMed, Cochrane Library and Embase were searched. Screening randomized controlled trials of probucol combined with statins for carotid plaque. The search period was from the establishment of the database until December 17, 2023. Statin therapy alone was the control group, and statin therapy combined with probucol was the combined group. The quality of included studies was assessed with reference to Cochrane bias risk assessment. The main outcome measures included the average carotid artery intima-media thickness (IMT), secondary outcome indicators included TC, hs-CRP, stroke events, etc. Meta-analysis was performed using RevMan 5.1 software. Results Eleven randomized controlled trials with a total of 3251 patients were included. Meta-analysis showed that the combined group was superior to the control group in reducing IMT [standardized mean difference (SMD) -0.93, 95%CI -1.66--0.20, P＜0.001]. The combined group was better than the control group in reducing TC level (SMD -1.08, 95%CI -1.60--0.55, P＜0.001). There was no significant difference in reducing hs-CRP level between the two groups (SMD -1.22, 95%CI -2.48-0.04, P=0.060). The combined group was superior to the control group in reducing stroke events (RR 0.34, 95%CI 0.17-0.65, P=0.001). Conclusions Probucol combined with statins is more effective in the treatment of carotid plaque, and can reduce the level of TC and the incidence of stroke events.
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