沙格列汀治疗2型糖尿病的Meta分析

目的系统评价沙格列汀治疗2型糖尿病的疗效和安全性。方法计算机检索Cochrane Library(2011年第2期)、PubMed(1978～2011.5),EMbase(1974～2011.5)、CNKI(1978～2011.5)、VIP(1989～2011.5)、CBM(1978～2011.5)。按照Cochrane系统评价方法查找沙格列汀治疗2型糖尿病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 5.0软件进行Meta分析。结果共纳入7个RCT。Meta分析结果显示:在降低患者糖化血红蛋白水平方面,不同剂量沙格列汀组均明显优于安慰剂组,其差异有统计学意义2.5 mg/d:MD=–0.65,95%CI(–0.81,–0.48),P<0.000 01;5 mg/d:MD=–0.74,95%CI(–0.88,–0.58),P<0.000 01;10 mg/d:MD=–0.66,95%CI(–0.82,–0.50),P<0.000 01];而不良反应发生率两组相似,其差异均无统计学意义2.5 mg/d:RR=1.03,95%CI(0.93,1.14),P=0.52;5 mg/d:RR=1.01,95%CI(0.95,1.07),P=0.7810 mg/d:RR=1.04,95%CI(0.96,1.12),P=0.33]。结论沙格列汀能有效控制2型糖尿病患者血糖,且安全性较好。但其远期疗效及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。

Saxagliptin in the Treatment of Type 2 Diabetes:A Meta-Analysis

Objective To evaluate the efficacy and safety of saxagliptin in type 2 diabetes patients.Methods The following databases as The Cochrane Library(Issue 2,2011),PubMed(1978 to May 2011),EMbase(1974 to May 2011),CNKI(1978 to May 2011),VIP(1989 to May 2011) and CBM(1978 to May 2011) were searched.The quality of included randomized controlled trials(RCTs) was assessed according to the Cochrane Collaboration system review,and then meta-analysis was performed using RevMan 5.0.Results A total of 7 RCTs were included.The results of meta-analyses showed that HbA1c was significantly reduced in the saxagliptin group than that in placebo group(MD= –0.69,95%CI –0.78 to –0.60,P<0.000 01).There was no significant difference in the incident rate of adverse reaction between two groups(RR=1.02,95%CI 0.98 to 1.06,P=0.26).Conclusion Saxagliptin is effective and safe for type 2 diabetes.But its long-term efficacy and safety still need to be confirmed by performing more high quality,large sample RCTs with long-term follow-up.