The prevention of theophylline on contrast-induced nephropathy—a meta analysis based on 19 RCTs
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摘要: 目的 系统评价茶碱类药物对造影剂肾病(CIN)的预防作用。 方法 按系统评价的要求,综合全面的查找茶碱类药物对造影剂相关肾损害预防的相关文献,采用RevMan 5.0软件进行Meta分析。 结果 共纳入19个随机对照研究(RCTs),茶碱类药物vs.其他预防治疗组,结果显示茶碱类药物比其他预防治疗能更有效地降低CIN的发生率(RR=0.39,95%CI:0.22~0.68,P=0.001),但比较血肌酐值差异无统计学意义(RR=0.03,95%CI:-0.11~0.18,P=0.650),且比较肾小球滤过率(GFR)值差异无统计学意义(RR=-3.24,95%CI:-29.60~23.11,P=0.810);茶碱类药物vs.安慰剂组,结果显示茶碱类药物比安慰剂能更有效地降低CIN的发生率(RR=0.44,95%CI:0.29~0.67,P<0.001),能更有效地降低血肌酐值(RR=-0.12,95%CI:-0.18~-0.07,P<0.001),更有效地升高GFR值(RR=11.82,95%CI:7.25~16.39,P<0.001)。 结论 基于现有资料,茶碱对造影剂相关肾损害有一定的预防作用,特别是对于年轻及不伴有糖尿病或高血压的患者。但由于采用亚组分析,导致亚组组内样本量少,上述结论尚需要更多高质量、大样本的随机盲法对照试验加以证实。Abstract: Objective To systematically evaluate the prophylactic effect of theophylline on the contrast-induced nephropathy(CIN). Methods Retrieve Chinese and English database in accordance with the requirements of system evaluation, comprehensively and comprehensively search for the relevant literature on theophylline drugs in the treatment of CIN. Meta analysis was carried out by using RevMan 5.0 software. Results Nineteen randomized controlled trials(RCTs) were included. In the group of theophylline vs. other preventive treatment, showed that theophylline can effectively reduce the incidence of CIN compared with other preventive treatment[RR=0.39, 95% CI:(0.22,0.68), P<0.001], but had no significant differences in serum creatinine value[RR=0.03, 95% CI:(-0.11,0.18), P=0.650] and had no significant differences in GFR value[RR=-3.24, 95% CI:(-29.60,23.11), P=0.810]. In the group of theophylline VS placebo, showed that theophylline can effectively decrease the incidence of CIN[RR=0.44, 95% CI:(0.29,0.67), P<0.001] and can effectively lower serum creatinine values[RR=-0.12, 95% CI:(-0.18,-0.07), P<0.001], can effectively increase GFR values[RR=11.82, 95% CI:(7.25,16.39), P<0.001]. Conclusion There are some prophylactic effects of theophylline on the CIN based on existing information, especially for the young patients without diabetes or high blood pressure. However, subgroup analysis resulted in less sample size in the subgroups, much more high-qualified RCTs with large samples and multicenter as well as strict design are needed to evaluate the treatment effect of theophylline on the CIN.
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Key words:
- Theophylline /
- Contrast-induced nephrology /
- Meta-analysis /
- Randomized controlled trial
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