非穿透性小梁手术联合应用丝裂霉素C治疗开角型青光眼的meta分析  

Intra-operative mitomycin C for nonpenetrating filtering surgery in treatment of open angle glaucoma: a systematic review and meta-analysis

作　　者：沈亚[1] 高连娣[1] 程金伟[1] 蔡季平[1] 李由[1] 魏锐利[1] 

机构地区：[1]第二军医大学长征医院眼科,上海200003

出　　处：《第二军医大学学报》2012年第9期1006-1010,共5页Academic Journal of Second Military Medical University

基　　金：国家自然科学基金(81000374;81170874);上海市自然科学基金(10ZR1439300);上海市青年科技启明星计划(12QA1404600)~~

摘　　要：目的评价非穿透性小梁手术联合使用丝裂霉素C对治疗开角型青光眼患者的疗效及耐受性的差异。方法检索MEDLINE、EMBASE、中国生物医学文献数据库、Cochrane图书馆,获得以往发表的相关论文,经筛选后共有8项临床对照试验纳入meta分析。比较非穿透性小梁手术联合使用与未使用丝裂霉素C的眼压下降百分比、治疗完全成功率、治疗总成功率和并发症等指标。使用RevMan 5.0软件进行统计分析。结果术后6、12、24、36个月非穿透性小梁手术联合使用丝裂霉素C组与单纯非穿透性小梁手术组眼压下降百分比的加权均数差分别为5.24%(95%CI,-3.24～13.72)、8.31%(95%CI,4.33～12.30)、9.56%(95%CI,4.88～14.24)、14.45%(95%CI,9.02～19.88),除术后6个月外的其余各个时间点两组之间差异均存在统计学意义(P<0.05)。非穿透性小梁手术联合使用丝裂霉素C组的治疗完全成功率较单纯非穿透性小梁手术组增加,治疗完全成功率的合并风险差在术后6、12、24、36个月分别为1.16(95%CI,1.05～1.27)、1.20(95%CI,1.05～1.38)、1.30(95%CI,1.05～1.61)、1.36(95%CI,1.06～1.73),各个时间点两组之间差异均存在统计学意义(P<0.05)。术中应用丝裂霉素C未出现与药物相关的并发症。结论联合应用丝裂霉素C可以改善非穿透性小梁手术的疗效,而且耐受性良好。Objective To compare the efficacy and tolerability between nonpenetrating filtering surgery with （NPFS-MMC） and without （NPFS-noMMC） intraoperative mitomycin C application for treatment open angle glaucoma. Methods Pertinent studies were selected through extensive searches of the Cochrane Library, PubMed, Embase, and Chinese Biomedicine Database. Eight controlled clinical trials meeting the pre-defined criteria were systematically reviewed by metaanalysis. The main outcome measures were percentage intraocular pressure reduction （IOPR%）, complete remission rate, total remission rate, and complications. The pooled estimates were carried out using RevMan version 5.0 software. Results The weighted mean differences of the IOPR% between the NPFS-MMC group and NPFS-noMMC group were 5. 24% （95% confidence intervals[95%CI], -3.24 to 13.72） after 6 months, 8.31% （95%CI,4.33 to 12.30） after 12 months（P〈0.05）, 9.56% （95%CI, 4.88 to 14.24） after 24 months（P〈（0.05）, and 14.45% （95%CI, 9.02 to 19.88） after 36 months（P〈0.05）. NPFS-MMC was associated with significant greater complete remission rates compared with NPFS-noMMC, with the pooled risk difference being 1.16 （95MCI, 1.05 to 1.27） after 6 months（P〈0.05）, 1.20 （95%CI, 1.05 to 1.38） after 12 months （P〈0.05）, 1.30 （95%CI, 1. 05 to 1. 61） after 24 months （P〈0.05）, and 1. 36 （95%CI, 1.06 to 1. 73） after 36 months （P〈0.05）. ]ntraoperative mitomycin C was not associated with any drug-induced complications. Conclusion The use of intraoperative mitomycin C is safe and can improve the effect of nonpenetrating filtering surgery in patients with open ganle glaucoma.

关 键 词：开角型青光眼 非穿透性小梁手术 丝裂霉素C META分析 

分 类 号：R775[医药卫生—眼科]