苯妥英钠对癫痫患者体内3种心血管疾病相关因子水平影响的Meta分析
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篇名: 苯妥英钠对癫痫患者体内3种心血管疾病相关因子水平影响的Meta分析
TITLE: Effects of Phenytoin on 3 Kinds of Cardiovascular Disease-related Factor in Patients with Epilepsy :A Meta-analysis
摘要: 目的:系统评价苯妥英钠对癫痫患者体内3种心血管疾病相关因子(叶酸、维生素B12、同型半胱氨酸)水平的影响,为临床治疗癫痫提供循证参考。方法:计算机检索PubMed、GoogleScholar、中国期刊全文数据库、中文科技期刊数据库、万方数据库,检索时限为1991年1月-2019年1月,收集使用苯妥英钠(试验组)对比未使用抗癫痫药(对照组)的癫痫患者血清中叶酸、维生素B12、同型半胱氨酸水平的观察性研究。对符合纳入标准的文献进行资料提取,并采用横断面研究评价标准(AHRQ)量表进行质量评价后,采用RevMan5.3软件和Stata11软件进行Meta分析。结果:共纳入10项研究,合计745例患者。Meta分析结果显示,试验组患者叶酸水平显著低于对照组[SMD=-0.90,95%CI(-1.18,-0.62),P<0.001],同型半胱氨酸水平显著高于对照组[SMD=1.22,95%CI(0.73,1.71),P<0.001];两组患者维生素B12水平比较,差异无统计学意义[SMD=-0.19,95%CI(-0.39,0.02),P>0.05]。结论:苯妥英钠可降低癫痫患者体内叶酸水平,升高其同型半胱氨酸水平。
ABSTRACT: OBJECTIVE:To systematically evaluate the effects of phenytoin on 3 kinds of cardiovascular disease-related factors (Folic acid ,vitamin B 12 and homocysteine)in epilepsy patients ,and to provide evidence-based reference for clinical treatment of epilepsy. METHODS :Retrieved from PubMed ,Google scholar ,CJFD,VIP and Wanfang database ,observational studies about using phenytoin (trial group ) versus using no antiepileptics (control group ) on the levels of folic acid ,vitamin B 12 and homocysteine in serum were collected during Jan. 1991-Jan. 2019. After data extraction of included literatures ,quality evaluation with evaluation criteria for cross-sectional study (AHRQ)scale,Rev Man 5.3 and Stata 11 softwares were used for statistical analysis. RESULTS :A total of 10 studies were included ,involving 745 patients. Meta-analysis showed that the folic acid level of trial group was significantly lower than control group [SMD =-0.90,95%CI(-1.18,-0.62),P<0.001];the level of homocysteine in trial group was significantly higher than control group [SMD =1.22,95%CI(0.73,1.71),P<0.001]. There was no significant difference in the levels of vitamin B 12 between 2 groups [SMD =- 0.19,95% CI(- 0.39,0.02),P>0.05]. CONCLUSIONS:Phenytoin can reduce the level of folic acid and increase the level of homocysteine in epilepsy patients.
期刊: 2020年第31卷第03期
作者: 张孟媛,吕媛,洪秀琴,易尚辉,刘桃成
AUTHORS: ZHANG Mengyuan,LYU Yuan,HONG Xiuqin,YI Shanghui,LIU Taocheng
关键字: 苯妥英钠;癫痫;叶酸;维生素B12;同型半胱氨酸;Meta分析
KEYWORDS: Phenytoin;Epilepsy;Folic acid ;Vitamin B 12;Homocysteine;Meta-analysis
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