曲美他嗪预防肾功能不全患者造影剂肾病的Meta分析

目的系统评价曲美他嗪(TMZ)预防肾功能不全患者造影剂肾病(CIN)的临床疗效。方法计算机检索PubMed、Embase、Cochrane Library、EBSCO与Scopus数据库,检索时间为建库至2018年12月,同时查阅相关会议摘要和网站。采用RevMan 5.3软件进行Meta分析。结果最终纳入符合要求的文献6篇,共920例患者。其中,TMZ(+)组456例,TMZ(-)组464例。荟萃分析结果显示,TMZ(+)组的CIN发生率明显低于TMZ(-)组(OR=0.31, 95%CI 0.20～0.48;P0.01);术后3 d内患者的血清肌酐值在TMZ(+)组更低,但与TMZ(-)组相比,尚未达到统计学差异(MD=-0.22, 95%CI-0.48～0.04;P=0.10)。结论 TMZ对预防肾功能不全患者CIN的发生具有积极作用。不过,TMZ对血清肌酐水平的真实影响,仍需要更多高质量、大样本的随机对照研究进一步证实。

Trimetazidine for prevention of contrast-induced nephropathy in patients with renal insufficiency:a Meta-analysis

Objective To systematically evaluate the efficacy of trimetazidine (TMZ) in the prevention of contrast-induced nephropathy (CIN) in patients with renal insufficiency. Methods The databases, including PubMed, Embase, Cochrane Library, EBSCO and Scopus from inception to December 2018 were searched for eligible trials evaluating the clinical efficacy of TMZ in the prevention of CIN. Meanwhile, we reviewed the relevant conference summary and websites. Meta-analysis was performed using RevMan 5.3 statistics. Results A total of 6 studies, involving 920 patients, with 456 patients in TMZ (+) group and 464 patients in TMZ (-) group were collected. Meta-analysis showed that the incidence of CIN in TMZ (+) group was significantly lower than TMZ (-) group (OR=0.31,5%CI 0.20-0.48; P<0.01). The serum creatinine (SCr) level was lower in TMZ(+) group than the other group within 3 d after procedure, but there was no statistical difference (MD=-0.22,5%CI -0.48-0.04; P=0.10). Conclusion TMZ shows a positive effect on the prevention of CIN in patients with renal insufficiency. However, more high-quality, large-sample randomized controlled trials are still needed to further confirm its efficacy.