目的 采用Meta-分析方法評(píng)價(jià)普羅布考對(duì)對(duì)比劑腎病的保護(hù)作用。方法 計(jì)算機(jī)檢索PubMed、EMbase、Web ofScience、The Cochrane Library、中國學(xué)術(shù)期刊全文數(shù)據(jù)庫（CNKI）、中國生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫（CBM）、維普中文期刊全文數(shù)據(jù)庫（VIP）和萬方數(shù)據(jù)庫，檢索時(shí)間均為建庫-2018年11月，收集應(yīng)用普羅布考預(yù)防對(duì)比劑腎病的隨機(jī)對(duì)照試驗(yàn)（RCT），評(píng)價(jià)納入RCT的偏倚風(fēng)險(xiǎn)，采用RevMan 5和Stata 12軟件進(jìn)行Meta-分析。結(jié)果 共納入14個(gè)RCTs，包括3503例患者。Meta-分析結(jié)果顯示：普羅布考組對(duì)比劑腎病的發(fā)生率顯著低于對(duì)照組[OR=0.321，95% CI （0.236~0.437），P=0.000]。術(shù)后24 h、48 h、72 h的肌酐水平，普羅布考組均低于對(duì)照組[SMD=-0.523，95% CI （-0.957~-0.106），P=0.014]、[SMD=-0.679，95% CI （-0.997~-0.362），P=0.000]、[SMD=-0.461，95% CI （-0.645~-0.277），P=0.000]。亞組分析結(jié)果顯示：普羅布考組對(duì)比劑腎病發(fā)生率和血肌酐水平均低于對(duì)照組，普羅布考組對(duì)比劑腎病發(fā)生率和血肌酐水平均低于對(duì)照組，而結(jié)合僅造影后水化兩組的差異無統(tǒng)計(jì)學(xué)意義；無論患者是否患有糖尿病，普羅布考組對(duì)比劑腎病發(fā)生率和血肌酐水平均低于對(duì)照組。結(jié)論 普羅布考結(jié)合造影前后水化及僅造影前水化對(duì)對(duì)比劑腎病有保護(hù)作用。受納入研究數(shù)量和質(zhì)量限制，上述結(jié)論仍需開展更多高質(zhì)量的隨機(jī)對(duì)照試驗(yàn)加以驗(yàn)證。

Objective To evaluate the protective effect of probucol on contrast-induced nephropathy using meta-analysis. Methods The databases of PubMed, EMBASE, Web of Science, The Cochrane Library, CNKI, CBM, VIP and WanFang Data were retrieved with computer for collecting the randomized controlled trials (RCT) about the prevention of contrast-induced nephropathy using probucol from the establishment of the databases to November 2018. The included RCTs were screened, extracted and reviewed on bias risk by two reviewers according to inclusion and exclusion criteria,and given Meta-analysis by using RevMan5 and STATA 12 software.Results A totally of 14 RCTs were included,including 3503 patients.The results of Meta-analysis showed that the incidence of CIN was significantly lower in probucol group than that in the control group[OR=0.321, 95%CI(0.236~0.437), P=0.000]. The level of serum creatinine (SCr) at 24 h, 48 h and 72 h were lower in probucol group than that in the control group[SMD=-0.523, 95%CI(-0.957~-0.106), P=0.014],[SMD=-0.679, 95%CI(-0.997~-0.362), P=0.000],[SMD=-0.461, 95%CI(-0.645~-0.277), P=0.000]. Subgroup analysis was carried out on the types of iodine contrast agents and the type of hydration. The results of subgroup analysis showed that the incidence of CIN and the level of SCr were lower in the probucol than those in the control group regardless of the non-ionic isotonic contrast agent or non-ionic low permeability contrast agent. No matter using hydration before and/or after using contrast agent, the incidence of CIN and the level of SCr in the probucol group were lower than those in the control group, while there was no significant difference between the two groups after using iodine contrast agent. Regardless of the patient had diabetes, the incidence of CIN was significantly lower in probucol group than that in the control group, and the level of SCr at 72 h was lower in probucol group than that in the control group. Conclusion Probucol combined with hydration before and after angiography and pre-contrast hydration has a protective effect on contrast nephropathy. Due to limited quantity and quality of the included studies, more high-quality studies were needed to verify above conclusions.