眼眶放射治疗对Graves眼病疗效的Meta分析  

A Meta-analysis of orbital irradiation in treatment of Graves ophthalmopathy

作　　者：高国红[1] 沈亚[1] 程金伟[1] 魏锐利[1] 马晓晔[1] 

机构地区：[1]第二军医大学第二附属医院眼科,上海200003

出　　处：《中国实用眼科杂志》2012年第6期710-714,共5页Chinese Journal of Practical Ophthalmology

基　　金：国家自然科学基金（81070758）

摘　　要：目的系统评价眼眶放疗治疗Graves眼病的疗效。方法应用计算机检索CochraneLi．brary、PubMed、EMbase、中国生物医学文献数据库、中国期刊全文数据库、中文科技期刊全文数据库和万方数据库，检索时间截止至2011年3月，并辅以手工检索、因特网搜索，全面查找符合纳入标准的随机对照试验（RCT），进行质量评价和资料提取后，采用RevMan5．0软件进行Meta分析。结果共纳入5个RCT，合计289例患者。Meta分析结果显示：2项研究表明与假放疗相比眼眶放疗可以有效治疗Graves眼病，2项研究表明眼眶放疗与口服糖皮质激素的治疗效果相当，2项研究表明眼眶放疗对突眼的症状改善无明显效果，它们的合并效应（合并OR值、合并OR值、合并均数差）分别为0．32[0．16，0．64]、0．89[0．40，1．94]、-0．30[-0．69，0．10]。结论眼眶放疗能有效改善Graves眼病治疗的总体有效率，其疗效与口服糖皮质激素的作用相当。Objective To evaluate the efficacy of orbital irradiation in the treatment of Graves ophthalmopathy. Methods Through computer searching The Cochrane Library, PubMed, EMbase, CBM, CKNI, VIP and Wanfang with a cut-off date in March 2011, and hand searching relevant jour- nals, the randomized controlled trails （RCTs） assessing the effect of orbital irradiation on Graves oph- thalmopathy were collected. Quality assessment and date extraction were performed in those clinical trials in lined with the inclusion criteria. Then, RevMan5.0 software was applied to carry out me- ta-analysis. Results Five relevant studies with 289 patients were included. The recta-analysis showed that： Two of them found orbital irradiation to be significantly more effective than sham irradiation; 2 of them found orbital irradiation to be equally effective as oral glucocorticoid; 2 of them found the effect of orbital irradiation on proptosis was insignificant. The pooled OR, pooled OR and pooled mean difference were 0.32 [0.16, 0.64], 0.89 [0.40, 1.94] and -0.30 [-0.69, 0.10] respectively. Conclusions This Meta-analysis demonstrates that orbital irradiation can effectively improve the over- all response rate of the treatment of Graves ophthalmopathy, and it is equally effective as oral gluco- corticoid.

关 键 词：眼眶放射治疗 GRAVES眼病 META分析 系统评价 

分 类 号：R581.1[医药卫生—内分泌]