非诺贝特对肾功能影响的Meta分析_《中国循证医学杂志》

作者：

徐川 , 袁自静 ,  朱江

南京市江宁医院肾内科（南京　211110）;

关键词：

非诺贝特尿酸系统评价 Meta分析随机对照试验半随机对照试验

DOI：

10.7507/1672-2531.20130233

视频：

导出 下载 收藏 扫码 引用

摘要 全文 图表 视频 参考文献 施引文献 补充材料

目的　系统评价非诺贝特对不同人群肾功能的影响，为临床上高尿酸血症治疗方案的选择提供参考。
方法　计算机检索PubMed（1966～2013）、EMbase（1984～2013）、The Cochrane Library（2012年第1期）、CBM（1978～2013）和CNKI（1989～2013）等数据库，同时手工检索《中西医结合杂志》及国内肾脏疾病相关杂志，纳入非诺贝特干预相关随机或半随机对照试验。按Cochrane系统评价方法，由2名评价员独立进行文献筛选、资料提取和评价纳入研究的方法学质量后，采用RevMan 5.0软件进行Meta分析。
结果　共纳入16个研究，包括346例患者。Meta分析结果显示：① 经非诺贝特治疗后，患者血清尿酸改善优于对照组［WMD=48.68，95%CI（10.02，87.34），P lt;0.000 01］；内生肌酐清除率较对照组下降［WMD=8.88，95%CI（1.29，16.47），P=0.002］；血清肌酐的变化与对照组差异无统计学意义［WMD=1.78，95%CI（–2.86，6.42），P=0.45］。② 不良反应主要有胃肠道不适、皮疹、GPT、转氨酶等一过性升高，但大多症状轻微。
结论　非诺贝特对于降低血尿酸有较好的疗效，但由于纳入文献方法学质量不高，确切疗效及有关毒副作用有待于设计严格的多中心、大样本、随机双盲临床对照试验进一步证实。

引用本文： 徐川,袁自静,朱江. 非诺贝特对肾功能影响的Meta分析. 中国循证医学杂志, 2013, 13(11): 1361-1366. doi: 10.7507/1672-2531.20130233 复制

1.	The FIELD study investigators. Effect of long term fenofibrate therapy on cardiovascular events in 9795 people with type 2 diabetes mellitus (the FIELD study): randomised controlled trial. Lancet, 2005, 366(9500): 1849.
2.	Bastow MD, Durrington PN, Ishola M. Hypertriglyceridemia and hyperuricemia: effects of two fibric acid derivatives (bezafibrate and fenofibrate) in a double-blind, placebo-controlled trial. Metabolism, 1988, 37(3): 217-220.
3.	Obermayr RP, Temml C, Gutjahr G, et al. Elevated uric acid increases the risk for kidney disease. J Am Soc Nephrol, 2008, 19(12): 2251-2253.
4.	Liamis G, Bairaktari ET, Eliasf M. Effect of fenofibrate on serum uric acid levels. Am J Kidney Dis, 1999, 34: 594.
5.	YamamokT, MoriwakiY, Takahashi S, et al. Effect offenofibrate on plasma concentration and urinary excretion of purine bases and oxyPurinol. Eur J ClinInvest, 2000, 30(10): 871-878.
6.	王慧华, 李开沪, 朱秀英. 微粒化非诺贝特与苯扎贝特治疗老年高脂血症和高尿酸血症的比较. 老年医学与保健, 1999, 5(2): 73-75.
7.	Elisaf M, Tsimichodimos V, Bairaktari E, et al. Effect of Micronized Fenofibrate and Losartan Combination on Uric Acid Metabolism in Hypertensive Patients with Hyperuricemia. Journal of Cardiovascular Pharmacology, 1999, 34(1): 60-63.
8.	张文姚, 任爱华, 蒋益忠. 自身交叉试验比较非诺贝特与辛伐他汀降脂疗效及对ApoA、ApoB的影响. 心血管康复医学杂志, 2000, 9(2): 35-37.
9.	王守俊, 刘瑞芳, 魏巧兰. 非诺贝特对糖尿病肾病的前瞻性研究. 辽宁实用糖尿病杂志, 2001, 9(3): 27-28.
10.	Giral P, Bruckert E, Jacob N, et al. Homocysteine and lipid lowering agents. A comparison between atorvastatin and fenobrate in patients with mixed hyperlipidemia. Atherosclerosis, 2001, 154(2): 421-427.
11.	Insua A, Massari F, Moncalvo JJR, et al. Fenofibrate of gemfibrozil for treatment of types IIa and IIb primary hyperlipoproteinemia: a randomized, double-blind, crossover study. Endocr Pract, 2002, 8(2): 96-101.
12.	秦利, 殷峻, 邢惠莉. 非诺贝特缓释微丸对糖尿病患者糖脂代谢紊乱的影响. 上海第二医科大学学报, 2003, 23(3): 261-263.
13.	Milionis HJ, Papakostas J, Kakafika A, et al. Comparative effects of atorvastatin, simvastatin, and fenofibrate on serum homocysteine levels in patients with primary hyperlipidemia. J Clin Pharmacol, 2003, 43(8): 825-830.
14.	孙学春. 微粒化非诺贝特对老年人血脂代谢紊乱的疗效观察. 四川医学, 2005, 26(9): 975-976.
15.	Filippatos TD, Kiortsis DN, Liberopoulos EN, et al. Effect of orlistat, micronised fenofibrate and their combination on metabolic parameters in overweight and obese patients with the metabolic syndrome: the FenOrli study. Curr Med Res Opin, 2005, 21(12): 1997-2006.
16.	刘玉庆, 史淑琴, 赵勇. 逐酸活血汤治疗原发性高尿酸血症并高三酰甘油血症30例的疗效观察. 中国实用医药, 2008, 3(34): 60-62.
17.	Ansquer JC, Dalton RN, Caussé E, et al. Effect of fenofibrate on kidney function: a 6-week randomized crossover trial in healthy people. Am J Kidney Dis, 2008, 51(6): 904-913.
18.	王一扬, 王亦凡, 高振英. 非诺贝特治疗高甘油三酯症和高尿酸症的疗效. 药学与临床, 2009, 12(12): 1787-1789.
19.	刘茜. 非诺贝特和普伐他汀调节血脂及尿酸的研究. 中华全科医学, 2010, 8(1): 60-62.
20.	王大鹏, 高燕燕. 非诺贝特和苯溴马隆治疗高尿酸血症的效果. 齐鲁医学杂志, 2010, 25(6): 524-527.
21.	Goto M. A comparative study of anti-inflammatory and antidyslipidemic effects of fenofibrate and statins on rheumatoid arthritis. Mod Rheumatol, 2010, 20(3): 238-243.
22.	Filippatos TD, Kiortsis DN, Liberopoulos EN, et al. Effect of orlistat, micronised fenofibrate and their combination on metabolic parameters in overweight and obese patients with the metabolic syndrome: the FenOrli study. Curr Med Res Opin, 2005, 21(12): 1997-2006.
23.	Milionis HJ, Elisaf MS. Management of hypertension and dyslipidaemia in patients presenting with hyperuricaemia: case histories. Curr Med Res Opin, 2000, 16(3): 164-170.
24.	Daskalopoulou SS, Tzovaras V, Mikhailidis DP, et al. Effect on serum uric acid levels of drugs prescribed for indications other than treating hyperuricaemia. Curr Pharm Des, 2005, 11(32): 4161-4175.
25.	Lipscombe J, Bargman JM. Fibrate-induced increase in blood urea and creatinine. Nephrol Dial Transplant, 2001, 16(7): 1515.
26.	Davis TME, Ting R, Best JD, et al. Effects of fenofibrate on renal function in patients with type 2 diabetes mellitus: the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) Study. Diabetologia, 2011, 54(2): 280–290.
27.	Katsiki N, Papanas N, Fonseca VA, et al. Uric acid and diabetes: is there a link? Curr Pharm Des, 2013, 19(27): 4930-4937.

1. The FIELD study investigators. Effect of long term fenofibrate therapy on cardiovascular events in 9795 people with type 2 diabetes mellitus (the FIELD study): randomised controlled trial. Lancet, 2005, 366(9500): 1849.
2. Bastow MD, Durrington PN, Ishola M. Hypertriglyceridemia and hyperuricemia: effects of two fibric acid derivatives (bezafibrate and fenofibrate) in a double-blind, placebo-controlled trial. Metabolism, 1988, 37(3): 217-220.
3. Obermayr RP, Temml C, Gutjahr G, et al. Elevated uric acid increases the risk for kidney disease. J Am Soc Nephrol, 2008, 19(12): 2251-2253.
4. Liamis G, Bairaktari ET, Eliasf M. Effect of fenofibrate on serum uric acid levels. Am J Kidney Dis, 1999, 34: 594.
5. YamamokT, MoriwakiY, Takahashi S, et al. Effect offenofibrate on plasma concentration and urinary excretion of purine bases and oxyPurinol. Eur J ClinInvest, 2000, 30(10): 871-878.
6. 王慧华, 李开沪, 朱秀英. 微粒化非诺贝特与苯扎贝特治疗老年高脂血症和高尿酸血症的比较. 老年医学与保健, 1999, 5(2): 73-75.
7. Elisaf M, Tsimichodimos V, Bairaktari E, et al. Effect of Micronized Fenofibrate and Losartan Combination on Uric Acid Metabolism in Hypertensive Patients with Hyperuricemia. Journal of Cardiovascular Pharmacology, 1999, 34(1): 60-63.
8. 张文姚, 任爱华, 蒋益忠. 自身交叉试验比较非诺贝特与辛伐他汀降脂疗效及对ApoA、ApoB的影响. 心血管康复医学杂志, 2000, 9(2): 35-37.
9. 王守俊, 刘瑞芳, 魏巧兰. 非诺贝特对糖尿病肾病的前瞻性研究. 辽宁实用糖尿病杂志, 2001, 9(3): 27-28.
10. Giral P, Bruckert E, Jacob N, et al. Homocysteine and lipid lowering agents. A comparison between atorvastatin and fenobrate in patients with mixed hyperlipidemia. Atherosclerosis, 2001, 154(2): 421-427.
11. Insua A, Massari F, Moncalvo JJR, et al. Fenofibrate of gemfibrozil for treatment of types IIa and IIb primary hyperlipoproteinemia: a randomized, double-blind, crossover study. Endocr Pract, 2002, 8(2): 96-101.
12. 秦利, 殷峻, 邢惠莉. 非诺贝特缓释微丸对糖尿病患者糖脂代谢紊乱的影响. 上海第二医科大学学报, 2003, 23(3): 261-263.
13. Milionis HJ, Papakostas J, Kakafika A, et al. Comparative effects of atorvastatin, simvastatin, and fenofibrate on serum homocysteine levels in patients with primary hyperlipidemia. J Clin Pharmacol, 2003, 43(8): 825-830.
14. 孙学春. 微粒化非诺贝特对老年人血脂代谢紊乱的疗效观察. 四川医学, 2005, 26(9): 975-976.
15. Filippatos TD, Kiortsis DN, Liberopoulos EN, et al. Effect of orlistat, micronised fenofibrate and their combination on metabolic parameters in overweight and obese patients with the metabolic syndrome: the FenOrli study. Curr Med Res Opin, 2005, 21(12): 1997-2006.
16. 刘玉庆, 史淑琴, 赵勇. 逐酸活血汤治疗原发性高尿酸血症并高三酰甘油血症30例的疗效观察. 中国实用医药, 2008, 3(34): 60-62.
17. Ansquer JC, Dalton RN, Caussé E, et al. Effect of fenofibrate on kidney function: a 6-week randomized crossover trial in healthy people. Am J Kidney Dis, 2008, 51(6): 904-913.
18. 王一扬, 王亦凡, 高振英. 非诺贝特治疗高甘油三酯症和高尿酸症的疗效. 药学与临床, 2009, 12(12): 1787-1789.
19. 刘茜. 非诺贝特和普伐他汀调节血脂及尿酸的研究. 中华全科医学, 2010, 8(1): 60-62.
20. 王大鹏, 高燕燕. 非诺贝特和苯溴马隆治疗高尿酸血症的效果. 齐鲁医学杂志, 2010, 25(6): 524-527.
21. Goto M. A comparative study of anti-inflammatory and antidyslipidemic effects of fenofibrate and statins on rheumatoid arthritis. Mod Rheumatol, 2010, 20(3): 238-243.
22. Filippatos TD, Kiortsis DN, Liberopoulos EN, et al. Effect of orlistat, micronised fenofibrate and their combination on metabolic parameters in overweight and obese patients with the metabolic syndrome: the FenOrli study. Curr Med Res Opin, 2005, 21(12): 1997-2006.
23. Milionis HJ, Elisaf MS. Management of hypertension and dyslipidaemia in patients presenting with hyperuricaemia: case histories. Curr Med Res Opin, 2000, 16(3): 164-170.
24. Daskalopoulou SS, Tzovaras V, Mikhailidis DP, et al. Effect on serum uric acid levels of drugs prescribed for indications other than treating hyperuricaemia. Curr Pharm Des, 2005, 11(32): 4161-4175.
25. Lipscombe J, Bargman JM. Fibrate-induced increase in blood urea and creatinine. Nephrol Dial Transplant, 2001, 16(7): 1515.
26. Davis TME, Ting R, Best JD, et al. Effects of fenofibrate on renal function in patients with type 2 diabetes mellitus: the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) Study. Diabetologia, 2011, 54(2): 280–290.
27. Katsiki N, Papanas N, Fonseca VA, et al. Uric acid and diabetes: is there a link? Curr Pharm Des, 2013, 19(27): 4930-4937.

《中国循证医学杂志》

非诺贝特对肾功能影响的Meta分析

摘要 全文 图表 视频 参考文献 施引文献 补充材料

上一篇

下一篇

Format

Content

《中国循证医学杂志》

非诺贝特对肾功能影响的Meta分析

摘要 全文 图表 视频 参考文献 施引文献 补充材料

上一篇

下一篇

Format

Content

摘要全文图表视频参考文献施引文献补充材料