Bevacizumab与Ranibizumab治疗新生血管性眼病的疗效及安全性的Meta分析  

Efficacy and safety in treatment of ocular neovascularization by Bevacizumab versus Ranibizumab： a meta-analysis

作　　者：麻南[1] 贺翔鸽[1] 

机构地区：[1]第三军医大学大坪医院眼科(麻南现在北京解放军第三0六医院眼科),重庆400042

出　　处：《中华眼科杂志》2010年第3期263-267,共5页Chinese Journal of Ophthalmology

摘　　要：目的评价Bevacizumab与Ranibizumab玻璃体腔内注射治疗新生血管性眼病的有效性及安全性。方法荟萃分析。采用Cochrane系统评价方法，检索Medline（1966至2009年）、EMbase（1966至2009年）、Cochrane图书馆（2009年）及中国生物医学文献数据库CBM（1979至2009年）有关Bevacizumab与Ranibizumab治疗新生血管性眼病的临床研究文献资料，按照纳入和排除标准限定研究对象，通过Jadad评分量表进行文献质量评估后，使用Cochrane协作网提供的RevMan4．2统计软件进行数据分析。Bevacizumab与Ranibizumab治疗新生血管性眼病的疗效和安全性比较采用合并效应检验，结果以z值表示。结果共纳入Bevacizumab与Ranibizumab治疗新生血管性眼病的临床对照研究7项（1620只眼）。各项研究中的疗效存在异质性，采用随机效应模型，将纳入的研究结果进行Meta分析。结果显示，Bevacizumab治疗组患者的logMAR视力从治疗前的-0．90314-0．0323提高至-0．7635±0．0214，平均提高了0．1396±0．0225；Ranibizumab治疗组患者的logMAR视力从治疗前的-0．9345±0．0194提高至-0．8050±0．0221，平均提高了0．1295．4-0．0203；两组患者治疗前后，logMAR视力差异无统计学意义（Z=0．56，P=0．57）。Bevacizumab治疗组患者的黄斑中心凹厚度从治疗前的（325．4±52．3）μm降至（269．1±21．3）μm，平均降低了（56．3±18．5）μm；Ranibizumab治疗组患者的黄斑中心凹厚度从治疗前的（342．0±45．1）μm降至（277．2±35．5）μm，平均降低了（67．8±23．2）μm，两组患者治疗前后，降低黄斑中心凹厚度的差异无统计学意义（Z=1．13，P=0．26）。Bevacizumab治疗组患者注射部位炎症发生率为4．1％（34／823只眼），Ranibizumab治疗组患者注射部位炎症发生率为3．8％（30／797只眼），两组患者注射部位炎症发生率差异无统计学意义（Z=0．74，P=0．46）。Bevacizumab治疗Objective To evaluate the efficacy and safety in treatment of ocular neovascularization by Bevacizumab versus Ranibizumab. Methods It was a systematic review and meta-analysis. According to evaluation guidelines of Cochrane collaboration, clinical controlled trials （CCTs） comparing Bevacizumab and Ranibizumab in treatment of ocular neovascularization were searched using Medline, EMbase, the Cochrane Library and CBM. Methodology qualities of literatures were performed by experienced researchers according to the Jadad Score. RevMan 4. 2 offered by Cochrane was used to do the meta-analysis. The differences of efficacy and safety in treatment of ocular neovascularization by Bevacizumab versus Ranibizumab were analyzed through statistical test for incorporative effect （the test results were shown by Z value）. Results Only 7 literatures came into meta-analysis （ 1620 eyes）. The result of analysis showed that Bevacizumab could improve the BCVA and cut down the CFF in treatment of ocular neovascularization, and that Bevacizumab did not display any statistically difference in improving best-corrected visual acuity（ converted to logMAR, Bevacizumab group, from -0. 9031 ±0. 0323 to -0. 7635 ±0. 0214, improving by 0. 1396 ± 0. 0225 ; Ranibizumab group, from - 0. 9345 ± 0. 0194 to - 0. 8050 ± 0. 0221, improving by O. 1295 ± 0. 0203, Z =0. 56, P = 0. 57）, and cutting down the central foveal thickness [ Bevacizumab group, from （325.4 ±52. 3）μm to （269. 1 ±21.3） μm, cutting down by（56. 3 ± 18.5） μm; Ranibizumab group, from （ 342. 0 ± 45. 1 ）μm to （277. 2 ± 35.5）μm, cutting down by （ 67. 8 ± 23. 2）μm, Z = 1.13, P = 0. 26 ] and safety [ inflammation at injection site, Bevacizumab group, 4. 1% （34/823 eyes ） ; Ranibizumab group, 3.8% （ 30/797 eyes） , Z = 0. 74, P = 0.46 ; subconjunctival hemorrhage, Bevacizumab group, 3.3 % （ 27/ 823 eyes ） ; Ranibizumab group, 3.4% （ 27/797 eyes ） , Z = 0. 98, P = 0. 33 ; total complications, Bevacizumab group, 10. 2% （84/

关 键 词：抗体 单克隆 新生血管化 病理性 眼疾病 META分析 

分 类 号：R779.6[医药卫生—眼科]