卢美根与噻吗心安治疗高眼压疗效对比的Meta分析  

A meta-analysis of therapy comparison between bimatoprost and timolol in ocular hypertention eye

作　　者：葛轶睿[1] 王理理[1] 程金伟[2] 黄振平[1] 

机构地区：[1]南京军区南京总医院眼科,210002 [2]上海第二军医大学第二附属医院眼科,200003

出　　处：《眼科研究》2009年第12期1120-1125,共6页Chinese Ophthalmic Research

摘　　要：目的研究卢美根与噻吗心安在青光眼与高眼压症患者中降压的有效性,并观察不良反应。方法检索PubMed、EMBASE、TheCochraneLibraryControlledTrialsRegister及中国生物医学文献数据库收录的有关卢美根与噻吗心安治疗青光眼与高眼压症的对照研究,并辅以手工检索、因特网搜索。对纳入的6项随机对照试验,针对眼压下降比例、达到目标眼压人数、药物不良反应3项内容进行综合分析。结果卢美根降眼压效果优于噻吗心安,差异有统计学意义(P<0.01)[合并的加权均数差(WMD)=-2.04%,95%CI(-2.44,-1.64)]。3篇文献报道随访3个月时达到目标眼压的患者人数,卢美根组与噻吗心安组比较差异有统计学意义(P<0.01)[合并危险比(RR)=1.87,95%CI(1.45,2.41)];2篇文献报道随访>6个月时达到目标眼压患者人数,卢美根组与噻吗心安组比较差异有统计学意义(P<0.01)[合并RR=1.60,95%CI(1.36,1.90)]。结膜充血及睫毛变长为拟前列腺素类抗青光眼药物2种较为常见的不良反应,其发生率卢美根组与噻吗心安组比较,差异均有统计学意义(P<0.01)[合并RR=4.18,95%CI(2.89,6.05)、RR=9.40,95%CI(5.62,15.71)]。结论卢美根在降低眼压的程度和随访不同时期达到目标眼压的人数方面均优于噻吗心安。除结膜充血及睫毛变长的发生率卢美根组高于噻吗心安组外,2种药物均未发现有严重的药物相关不良反应。Objective Many researches have demonstrated the lowing-intraocular pressure（IOP）effects of bimatoprost and timolol.However,no powerful evidence showed which drug has the better efficacy.This study was to perform a meta-analysis to evaluate the efficacy and tolerability of bimatoprost compared with latanoprost in lowing IOP.MethodsThis was a evidence-based medicine science study.Pertinent studies were identified through searches of PubMed,EMBASE,the Cochrane Liberary Controlled Trials Register and Chinese Biomedicine Database using the terms of timolol,blocardren,temserin,timoptic,bimatoprost,lumigan.The intensive searching by hand and up to October 1,2008 was also designed.ResultsSix randomized and controlled studies enrolling a total of 2094 patients were included in the meta-analysis and three clinical indexes were analyzed.Bimatoprost was associated with greater decline value from baseline IOP in comparison with timolol（P〈0.01）with a weight mean difference-2.04 at final point（95% CI：-2.44 to-1.64）.Numerically greater proportions of bimatoprost patients than timolol patients achieved the target IOP at 3 months（from 3 literature）and 〉6 months（from 2 literature）with a pooled RR of 1.87（95% CI：1.45 to 2.41）,1.60（95% CI：1.36 to 1.90）（P〈0.01）,respectively.Bimatoprost showed a more frequencies in the adverse effects such as conjunctival hyperemia and eyelash growth than timolol with an RR of 4.18（95% CI：2.89 to 6.05）,9.40（95% CI：5.62 to 15.71）.No obvious drug-related side effect was found from literature analysis included both drugs.ConclusionSearched literature offers grade A of evidences for the comparison clinical evaluation of therapy efficacy between bimatoprost and timolol in lowing IOP.Bimatoprost has a better efficacy in lowering IOP and reaching comparable proportions of patients with target IOP than timolol.Both agents are well tolerated.

关 键 词：卢美根 噻吗心安 高眼压 META分析 循证医学 

分 类 号：R775[医药卫生—眼科] R988.1[医药卫生—临床医学]