维生素E的补充对冠状动脉粥样硬化的影响：一项系统回顾和荟萃分析-现代医学

维生素E的补充对冠状动脉粥样硬化的影响：一项系统回顾和荟萃分析

单位：1. 皖南医学院麻醉学院, 安徽芜湖 241000;
2. 皖南医学院药学院, 安徽芜湖 241000;
3. 皖南医学院第二附属医院心血管内科, 安徽芜湖 241000

分类号：R452

出版年·卷·期（页码）：2025·53·第七期（1050-1058）

摘要：

目的：系统评价维生素E的补充对冠状动脉粥样硬化的有效性和影响。方法：计算机检索中国知网、中国生物医学文献数据库、PubMed、Web of Science、Cochrane Library等中英文数据库，时限为建库至2024年8月19日。采用Review Manager 5.4软件对受试者低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、总胆固醇(TC)、甘油三酯(TG)、f2-异前列腺素、高敏C反应蛋白(hsCRP)和硫代巴比妥酸反应物(TBARS)水平进行Meta分析。结果：最终纳入12项随机对照试验(RCT)，合计585名受试者，具有冠状动脉粥样硬化或其他冠心病危险因素的患者使用维生素E或在常规用药基础上加用维生素E，对照组予以安慰剂或常规药物治疗。Meta分析结果显示，实验组TBARS降低水平高于对照组(MD=-1.59，95%CI -2.04～-1.13，P<0.001)，但两组在LDL-C、HDL-C、TC、TG、f2-异前列腺素和hsCRP变化方面的差异均无统计学意义(P>0.05)。结论：当前证据表明，补充维生素E能够显著降低受试者TBARS水平，但其对受试者LDL-C、HDL-C、TC、TG、f2-异前列腺素和hsCRP水平均无明显影响。受纳入研究的质量和数量的限制，上述研究成果需要更多高质量研究予以证实。

Objective: To systematically evaluate the effectiveness and impact of vitamin E supplementation on coronary atherosclerosis.Methods: We conducted a computer-based search of Chinese and English databases, including CNKI, CBM, PubMed, Web of Science, and the Cochrane Library, from their inception to August 19, 2024. Review Manager 5.4 software was used to perform a Meta-analysis on the levels of low-density lipoprotein cholesterol(LDL-C), high-density lipoprotein cholesterol(HDL-C), total cholesterol(TC), triglycerides(TG), f2-isoprostanes, hypersensitive C-reactive protein(hsCRP), and thiobarbituric acid reactive substances(TBARS) in the participants. Results: A total of 12 randomized controlled trials(RCTs) involving 585 participants were included in the Meta-analysis. The experimental group consisted of patients with coronary atherosclerosis or other risk factors for coronary heart disease who received vitamin E or vitamin E in addition to conventional medication, while the control group received a placebo or conventional medication. The Meta-analysis revealed that the experimental group had a significantly greater reduction in TBARS levels compared to the control group(MD=-1.59, 95%CI -2.04- -1.13, P<0.001). However, there were no statistically significant differences between the two groups in terms of changes in LDL-C, HDL-C, TC, TG, f2-isoprostanes, and hsCRP levels(P>0.05).Conclusion: Current evidence suggests that vitamin E supplementation can significantly reduce TBARS levels in subjects, but it does not appear to have a significant impact on LDL-C, HDL-C, TC, TG, f2-isoprostanes, and hsCRP levels. Due to the limitations in the quality and quantity of the included studies, these findings require further confirmation through more high-quality research.

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