中国血液净化 ›› 2014, Vol. 13 ›› Issue (03): 146-151.doi: 10.3969/j.issn.1671-4091.2014.03.006

• 临床研究 • 上一篇    下一篇

烟酸及烟酰胺对维持性透析患者血磷影响的系统评价

王沫,何辉,刘丁,胡建敏,郭颖   

  1. 南方医科大学珠江医院器官移植科
  • 收稿日期:2013-09-02 修回日期:2013-09-11 出版日期:2014-03-12 发布日期:2014-03-12
  • 通讯作者: 郭颖 ammoguoying@163.com E-mail:ammoguoying@163.com

Effect of nicotinic acid and nicotinamide on serum phosphorus levels in dialysis patients: a systematic

  • Received:2013-09-02 Revised:2013-09-11 Online:2014-03-12 Published:2014-03-12

摘要: 目的 评价应用烟酸及烟酰胺治疗维持性透析患者高磷血症的疗效及安全性。方法 运用Cochrane 图书馆、PubMed、EMbase、中国期刊全文数据库(CNKI)、万方数据库和维普期刊数据库检索使用烟酸或烟酰胺治疗维持性透析患者高磷血症的临床试验,经过质量评估和数据提取,对符合标准的研究进行系统评价。结果 13项研究中共有328名维持性透析患者(13例为腹膜透析患者,其余均为血液透析患者)入选,Meta分析结果显示治疗组/用药后同对照组/用药前相比,血磷、钙磷乘积的下降具有统计学意义,而血钙、甲状旁腺激素及血小板计数的变化不具有统计学意义。结论 目前证据显示,烟酸及烟酰胺可降低维持性透析患者的血磷,临床使用安全有效。但因纳入文献的质量和样本量有限,因此需要大样本及高质量的临床试验来提供更好的循证证据。

关键词: 烟酸, 烟酰胺, 维持性透析, 高磷血症, Meta分析

Abstract: Objective To assess the effect and safety of nicotinic acid and nicotinamide in treatment of hyperphosphatemia in dialysis patients by meta analysis. Methods Cochrane Library, PubMed, EMbase, CNKI, Wanfang Database and Weipu Database were used to do literature search on clinical trials studies in the treatment of hyperphosphatemia in dialysis patients by nicotinic acid or nicotinamide. After quality assessments and data extractions, all clinical trials accorded with standard were given a Mata analysis. Results A total of 328 maintenance dialysis patients (13 in peritoneal dialysis and the rest of patients in hemodialysis) in the 13 reports were analyzed. The results of Meta analysis showed that the level of serum phosphorus and calcium-phosphorus product decreased significantly after the treatment of nicotinic acid and nicotinamide, and there was no statistically difference in serum calcium, iPTH , platelet count between the treatment (or post-treatment) group and the control (or pre-treatment) group. Conclusion The current limited evidence suggests that nicotinic acid and nicotinamide are effective and safe in controlling serum phosphorus in dialysis patients. Because of the limits of the sample and quality of included studies, this conclusion has to be verified with more strictly desigened large clinical trials.

Key words: nicotinic acid, nicotinamide, maintenance dialysis, hyperphosphatemia, meta analysis