目的 系統(tǒng)評(píng)價(jià)依折麥布聯(lián)合他汀類(lèi)藥物與單藥應(yīng)用雙倍劑量他汀調(diào)血脂治療中對(duì)主要心血管事件的影響。方法 檢索CENTRAL、PubMed、EMBASE、中國(guó)生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫(kù)（CBM）、中國(guó)學(xué)術(shù)期刊全文數(shù)據(jù)庫(kù)（CNKI）和萬(wàn)方等數(shù)據(jù)庫(kù)，收集依折麥布聯(lián)合他汀類(lèi)藥物與雙倍劑量他汀類(lèi)藥物調(diào)脂治療心血管不良事件的隨機(jī)對(duì)照試驗(yàn)（RCT），檢索時(shí)限均從建庫(kù)至2018年4月1日。由2名評(píng)價(jià)員獨(dú)立篩選文獻(xiàn)、提取資料并評(píng)價(jià)納入研究的方法學(xué)質(zhì)量，采用RevMan 5.3和R3.3.1軟件進(jìn)行數(shù)據(jù)分析。結(jié)果 共納入16個(gè)RCTs，共3 534例患者。Meta-分析結(jié)果顯示與單藥應(yīng)用雙倍劑量他汀組相比，依折麥布聯(lián)合他汀組可降低心絞痛［RR=0.36，95% CI（0.21，0.63），P=0.000 3］、心肌梗死［RR=0.59，95% CI（0.36，0.95），P=0.03］和主要心血管不良事件（心源性死亡、心絞痛、心肌梗死、血運(yùn)重建）［RR=0.58，95% CI（0.38，0.87），P=0.009］的發(fā)生風(fēng)險(xiǎn)，且具有統(tǒng)計(jì)學(xué)差異；兩組血運(yùn)重建、心源性死亡、卒中和全因死亡風(fēng)險(xiǎn)無(wú)統(tǒng)計(jì)學(xué)差異。結(jié)論 現(xiàn)有證據(jù)表明依折麥布聯(lián)合他汀類(lèi)藥物比單藥應(yīng)用雙倍劑量他汀能進(jìn)一步降低不良心血管事件發(fā)生風(fēng)險(xiǎn)，但上述結(jié)果尚需更多多中心、大樣本隨機(jī)對(duì)照試驗(yàn)進(jìn)一步證實(shí)。

Objective To systemically review ezetimibe combining statins versus double-dose statins therapy on major cardiovascular diseases. Methods Relative randomized controlled trials (RCT) about ezetimibe combining statins versus doubledose statins therapy for treating major adverse cardiovascular events were searched in Cochrane Library, PubMed, EMBASE, CBM database, CNKI database, and Wanfang database from their inception to April 1, 2018. Two reviewers independently screened literature, extracted data, and evaluated the methodological quality of included studies. The meta-analysis was conducted by using RevMan 5.3 and R 3.3.1 software. Results A total of 16 RCTs involving 3 534 patients were included. The results of meta-analysis showed that compared with double-dose statins therapy, ezetimibe combining statins significantly decreased the incidence of angina[RR=0.36, 95%CI(0.21, 0.63), P=0.0003], myocardial infarction[RR=0.59, 95%CI(0.36, 0.95), P=0.03] and major adverse cardiovascular events (cardiogenic death, angina, myocardial infarction, revascularization)[RR=0.58, 95%CI(0.38, 0.87), P=0.009]. However, no statistic difference was found in revascularization, cardiogenic death, stroke, and all-cause mortality. Conclusion Current evidence shows that compared with double-dose statins therapy, ezetimibe combining statins therapy can reduce the risk of cardiovascular events. However, more multicentre and large-scale RCTs need to be conducted to verify this conclusion.