目的 系统评价阿托伐他汀对比瑞舒伐他汀对经皮冠状动脉介入（PCI）术后远期心功能及不良心血管事件（MACE）的影响。方法 计算机检索中国学术期刊全文数据库（CNKI）、维普中文期刊全文数据库（VIP）、中国生物医学文献数据库（CBM）、万方数据库、PubMed、Cochrane Library和Web of Science，搜集阿托伐他汀对比瑞舒伐他汀治疗心脏病患者PCI术后的临床随机对照试验（RCT），检索时限从建库至2020年10月30日，采用RevMan 5.3软件进行Meta分析。结果 共纳入14项RCTs，2 693例患者。Meta分析结果显示：阿托伐他汀组左心室射血分数（LVEF）小于瑞舒伐他汀组[MD=-5.56，95% CI=（-7.56，-3.56），P<0.01]，MACE高于瑞舒伐他汀组[RR=1.51，95% CI=（1.23，1.85），P<0.01]，超敏C-反应蛋白（hs-CRP）高于瑞舒伐他汀组[RR=0.79，95% CI=（0.40，1.18），P<0.01]，总胆固醇（TC）高于瑞舒伐他汀组[RR=0.45，95% CI=（0.35，0.54），P<0.01]，而支架内再狭窄[RR=1.17，95% CI=（0.84，1.63），P=0.36]和不良反应[RR=1.12，95% CI=（0.89，1.41），P=0.33]与瑞舒伐他汀组比较无显著差异。结论 瑞舒伐他汀对心脏疾病患者PCI术后远期心功能改善程度、降低hs-CRP和TC水平，减少MACE的发生均优于阿托伐他汀，但该结果仍需大样本、高质量的RCT验证。

Objective To systematically evaluate the effects of atorvastatin vs rosuvastatin on long-term cardiac function and major adverse cardiac events (MACE) after percutaneous coronary intervention (PCI). Methods Chinese and English databases including CNKI, VIP, CBM, WanFang, PubMed, Cochrane Library and Web of Science were searched by computer to collect the randomized controlled trials (RCTs) on atorvastatin vs rosuvastatin treatment of patients with heart disease after PCI from the database establishment to October 30, 2020. The Meta-analysis was performed by using RevMan 5.3 software. Results A total of 14 RCTs were included, involving 2 639 patients. The results of Meta analysis showed that LVEF% in atorvastatin group was lower than that in rosuvastatin group[MD=-5.56, 95%CI=(-7.56, -3.56), P<0.01], MACE was higher than rosuvastatin group[RR=1.51, 95%CI=(1.23, 1.85), P<0.01], high sensitive c-reactive protein (hs-CRP) levels was higher than that in rosuvastatin group[RR=0.79, 95%CI=(0.40, 1.18), P<0.01], total cholesterol (TC) levels was higher than rosuvastatin[RR=0.45, 95%CI=(0.35, 0.54), P<0.01], and In-stent restenosis[RR=1.17, 95%CI=(0.84, 1.63), P=0.36] and adverse reactions[RR=1.12, 95%CI=(0.89, 1.41), P=0.33] were not significantly different from those in the rosuvastatin group. Conclusion Rosuvastatin is superior to atorvastatin in terms of long-term improvement of cardiac function, reduction of hs-CRP and TC levels, and reduction of MACE after PCI in patients with heart disease, but the results of this study need to be validated by a large, high quality RCT.

R972

湖北省自然科学基金项目（2015CFC823）