铁胺和铁胺类利尿剂治疗结石复发:随机对照试验的系统审查和网络元分析
Alessandro V Oliveira1,2, Ana Luiza N Sampaio3,4, Rui W Mascarenhas3,5
1Department of Medicine, University of Pará State, Belém, Brazil. alessandrovidaloliv@outlook.com.
World journal of urology
|December 15, 2025
概括
thiazide (THZ) 和 thiazide-like (TL) 利尿剂经常用于预防结石 (KS),但证据有限. 这次元分析发现一些THZ/TL利尿剂与安慰剂不同,但总体证据不支持常规使用,需要进一步研究.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 药理学 药理学是指药理学的学科.
- 基于证据的医学 基于证据的医学
背景情况:
- thiazide (THZ) 和 thiazide-like (TL) 利尿剂是石 (KS) 复发预防的标准建议.
- 目前的指导方针建议THZ/TL利尿剂,尽管支持其有效性和安全性的高质量证据有限.
- 不同THZ/TL尿剂剂用于KS预防的最佳使用和有效性尚不清楚.
研究的目的:
- 系统地评估不同剂量的THZ和TL利尿剂在预防石复发方面的疗效和安全性.
- 综合随机对照试验 (RCT) 的证据,为临床实践准则提供信息.
- 确定特定的利尿剂和剂量,这些剂量在KS预防方面具有显著的益处.
主要方法:
- 在主要数据库 (PubMed,Web of Science,Embase,CENTRAL) 和临床试验注册表中进行了全面的文献搜索,截至2025年1月.
- 包括随机对照试验 (RCT),以临床或放射性石复发为主要结局.
- 进行了频率的随机效应网络元分析,以估计有效性和安全性结果的几率比率 (OR).
主要成果:
- 分析了9项涉及999名参与者的试验.
- 与安慰剂相比,甲基50 mg/d (OR:0.18),甲基50 mg/d (OR:0.52) 和三甲基4 mg/d (OR:0.26) 在统计学上显著地减少了KS复发.
- 对于甲或甲,没有观察到显著的剂量依赖性影响;三甲4毫克/天与增加的不良反应相关 (OR:49.96).
结论:
- 尽管有一些具有统计学意义的发现,但目前THZ/TL利尿剂在预防KS复发方面的证据基础有限,不支持常规处方.
- 现有研究的局限性凸显了需要谨慎的需要,并建议不应定期使用THZ/TL尿剂进行KS预防.
- 迫切需要进一步的高质量,精心设计的试验,包括对比,以确定KS预防策略的最终证据.
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