目的 系统评价碳酸镧治疗终末期肾脏病(ESRD)高磷血症的有效性及安全性.方法 通过计算机检索Cochrane图书馆、MEDLINE、EMBASE、CNKI、万方数据库,文献检索起止时间为1996年1月至2011年12月.收集碳酸镧治疗ESRD高磷血症的随机对照试验(RCT),应用Rev Man 5.1软件对数据进行Meta分析.结果 共纳入6篇文献,12个RCT,包括1688例患者.Meta分析结果显示,有效性分析:碳酸镧组血磷达标率与碳酸钙组相似[RR=1.00,95％ CI (0.92 ～ 1.09),P=0.97],高于安慰剂组[RR=4.69,95％ CI (2.63～ 8.39),P＜0.01](剂量≤1500 mg)及[RR=18.92,95％ CI(7.42～48.22),P＜0.01](剂量＞1500 mg)；碳酸镧组血钙磷乘积降低幅度与碳酸钙组相似[MD=-0.91,95％ CI(-7.18～ 5.36),P=0.78],大于安慰剂组[MD=-10.50,95％ CI(-15.89-5.10),P＜0.01].安全性分析:碳酸镧组高钙血症发生率低于碳酸钙组[RR=0.06,95％ CI(0.01～ 0.72),P=0.03].常见消化道不良反应中,碳酸镧组恶心[RR=1.80,95％CI(0.70～4.64),P=0.22]、呕吐[RR=3.94,95％CI(0.45～ 34.38),P=0.22]、便秘[RR=0.82,95％ CI(0.49～ 1.37),P=0.45]发生率与碳酸钙组相似,与安慰剂相比,恶心[RR=1.55,95％ CI(0.50～ 4.78),P=0.44]、呕吐[RR=2.07,95％ CI(0.38～ 11.30),P=0.40]发生率相似,便秘[RR=0.19,95％ CI(0.06～ 0.59),P＜0.01]发生率低.结论 应用碳酸镧治疗ESRD高磷血症的有效性与碳酸钙相似；与碳酸钙治疗组相比,碳酸镧治疗组高钙血症发生率较低,恶心、呕吐、便秘等常见消化道不良反应发生率相似.
目的 繫統評價碳痠鑭治療終末期腎髒病(ESRD)高燐血癥的有效性及安全性.方法 通過計算機檢索Cochrane圖書館、MEDLINE、EMBASE、CNKI、萬方數據庫,文獻檢索起止時間為1996年1月至2011年12月.收集碳痠鑭治療ESRD高燐血癥的隨機對照試驗(RCT),應用Rev Man 5.1軟件對數據進行Meta分析.結果 共納入6篇文獻,12箇RCT,包括1688例患者.Meta分析結果顯示,有效性分析:碳痠鑭組血燐達標率與碳痠鈣組相似[RR=1.00,95％ CI (0.92 ～ 1.09),P=0.97],高于安慰劑組[RR=4.69,95％ CI (2.63～ 8.39),P＜0.01](劑量≤1500 mg)及[RR=18.92,95％ CI(7.42～48.22),P＜0.01](劑量＞1500 mg)；碳痠鑭組血鈣燐乘積降低幅度與碳痠鈣組相似[MD=-0.91,95％ CI(-7.18～ 5.36),P=0.78],大于安慰劑組[MD=-10.50,95％ CI(-15.89-5.10),P＜0.01].安全性分析:碳痠鑭組高鈣血癥髮生率低于碳痠鈣組[RR=0.06,95％ CI(0.01～ 0.72),P=0.03].常見消化道不良反應中,碳痠鑭組噁心[RR=1.80,95％CI(0.70～4.64),P=0.22]、嘔吐[RR=3.94,95％CI(0.45～ 34.38),P=0.22]、便祕[RR=0.82,95％ CI(0.49～ 1.37),P=0.45]髮生率與碳痠鈣組相似,與安慰劑相比,噁心[RR=1.55,95％ CI(0.50～ 4.78),P=0.44]、嘔吐[RR=2.07,95％ CI(0.38～ 11.30),P=0.40]髮生率相似,便祕[RR=0.19,95％ CI(0.06～ 0.59),P＜0.01]髮生率低.結論 應用碳痠鑭治療ESRD高燐血癥的有效性與碳痠鈣相似；與碳痠鈣治療組相比,碳痠鑭治療組高鈣血癥髮生率較低,噁心、嘔吐、便祕等常見消化道不良反應髮生率相似.
목적 계통평개탄산란치료종말기신장병(ESRD)고린혈증적유효성급안전성.방법 통과계산궤검색Cochrane도서관、MEDLINE、EMBASE、CNKI、만방수거고,문헌검색기지시간위1996년1월지2011년12월.수집탄산란치료ESRD고린혈증적수궤대조시험(RCT),응용Rev Man 5.1연건대수거진행Meta분석.결과 공납입6편문헌,12개RCT,포괄1688례환자.Meta분석결과현시,유효성분석:탄산란조혈린체표솔여탄산개조상사[RR=1.00,95％ CI (0.92 ～ 1.09),P=0.97],고우안위제조[RR=4.69,95％ CI (2.63～ 8.39),P＜0.01](제량≤1500 mg)급[RR=18.92,95％ CI(7.42～48.22),P＜0.01](제량＞1500 mg)；탄산란조혈개린승적강저폭도여탄산개조상사[MD=-0.91,95％ CI(-7.18～ 5.36),P=0.78],대우안위제조[MD=-10.50,95％ CI(-15.89-5.10),P＜0.01].안전성분석:탄산란조고개혈증발생솔저우탄산개조[RR=0.06,95％ CI(0.01～ 0.72),P=0.03].상견소화도불량반응중,탄산란조악심[RR=1.80,95％CI(0.70～4.64),P=0.22]、구토[RR=3.94,95％CI(0.45～ 34.38),P=0.22]、편비[RR=0.82,95％ CI(0.49～ 1.37),P=0.45]발생솔여탄산개조상사,여안위제상비,악심[RR=1.55,95％ CI(0.50～ 4.78),P=0.44]、구토[RR=2.07,95％ CI(0.38～ 11.30),P=0.40]발생솔상사,편비[RR=0.19,95％ CI(0.06～ 0.59),P＜0.01]발생솔저.결론 응용탄산란치료ESRD고린혈증적유효성여탄산개상사；여탄산개치료조상비,탄산란치료조고개혈증발생솔교저,악심、구토、편비등상견소화도불량반응발생솔상사.
Objective To assess the efficacy and safety of lanthanum carbonate in treatment of hyperphosphatemia in end-stage renal disease (ESRD).Methods Randomized controlled trails of lanthanum carbonate in treatment of hyperphosphatemia in ESRD patients were searched in the database of MEDLINE,Cochrane Central Register of Controlled Trials,EMBASE,CNKI,Wanfang database.Data extracted from the literatures were analyzed with the Cochrane Collaboration's RevMan 5.1 software.Results Lanthanum carbonate group was similar with calcium carbonate group in treating hyperphosphatemia[RR =1.00,95 ％ CI (0.92-1.09),P =0.97],and more effective than placebo [RR=4.69,95％ CI (2.63-8.39),P＜ 0.01] (intervention dose≤ 1500 mg) and [RR =18.92,95％ CI (7.42-48.22),P ＜ 0.01] (intervention dose ＞ 1500 mg).In comparison with calcium carbonate group,the incidence of hypercalcinemia of lanthanum carbonate group was lower [RR =0.06,95 ％ CI (0.01-0.72),P =0.03],while the incidence of nausea [RR =1.80,95 ％ CI(0.70-4.64),P =0.22],vomiting [RR =3.94,95％ CI (0.45-34.38),P=0.22] and constipation [RR=0.82,95％ CI (0.49-1.37),P=0.45] were similar.The incidence of nausea and vomiting of lanthanum carbonate group were similar with placebo,with lower incidence of constipation [RR =0.19,95 ％ CI (0.06-0.59),P ＜ 0.01].Conclusions The efficacy of lanthanum carbonate in treating hyperphosphatemia is similar with calcium carbonate.The incidence of hypercalcinemia of lanthanum carbonate is lower than that of calcium carbonate,and the incidence of gastrointestinal adverse effect such as nausea,vomiting and constipation are similar with calcium carbonate.
