替米沙坦对比氯沙坦治疗原发性高血压的疗效与安全性的Meta分析

目的:系统评价替米沙坦对比氯沙坦治疗原发性高血压的疗效与安全性,以为临床提供循证参考。方法:计算机检索Cochrane图书馆、Medline、PubMed、EMBase、中国期刊全文数据库、中文科技期刊全文数据库、中国生物医学文献数据库,全面收集替米沙坦与氯沙坦治疗原发性高血压的随机对照试验(RCT),对符合纳入标准的文献进行质量评价,并运用Rev Man 5.0统计软件进行Meta分析。结果:共纳入11项RCT,合计1 907例患者。Meta分析结果显示,替米沙坦降低患者收缩压[MD=-3.37,95%CI(-4.99,-1.75),P<0.000]、舒张压[MD=-2.76,95%CI(-4.04,-1.49),P<0.000]及降压有效率[RR=1.14,95%CI(1.05,1.24),P=0.002]均显著优于氯沙坦,两组比较差异均有统计学意义;两组患者不良反应发生率比较差异无统计学意义[RR=0.91,95%CI=(0.74,1.12),P=0.38]。结论:替米沙坦治疗原发性高血压疗效优于氯沙坦,安全性相似。

Meta-analysis of Efficacy and Safety of Telmisartan and Losartan in the Treatment of Essential Hypertension

OBJECTIVE： To systematically evaluate the efficacy and safety of telmisartan and losartan in the treatment of essen- tial hypertension, and to provide evidence-based reference for clinical use. METHODS： Retrieved from Cochrane library, Med- line, PubMed, EMBase, CNKI, VIP and CBM database by computer, randomized controlled trials （RCT） about telmisartan ver- sus losartan in the treatment of essential hypertension were collected. The methodological quality of the included studies was evaluat- ed and Meta-analysis was drawn by Rev Man 5.0 statistical sofetware. RESULTS： A total of 11 RCT were included, involving 1 907 pa- tients. The results of meta-analysis revealed that telmisartan was better than losartan in systolic blood pressure reduction [MD= -- 3.37, 95 % CI （ - 4.99, - 1.75）, P（0.000], diastolic blood pressure reduction [MD = - 2.76, 95 % CI （ - 4.04, - 1.49）, P（ 0.000] and therapeutic responses [RR= 1.14, 95 % CI （1.05, 1.24）, P= 0.002] ; there was statistical significance. There were no significant difference in ADR [RR = 0.91, 95 % CI （0.74, 1.12）, P= 0.38]. CONCLUSIONS： Telmisartan is more effective than losartan in the treatment of essential hypertension, and they have similar safety.