雷珠单抗联合激光光凝对糖尿病黄斑水肿疗效的系统评价  

Effect of ranibizumab joint laser photocoagulation on diabetic macular edema: a systematic review

作　　者：程里礼 程秋霞[3] 马建青[2] 张超[1] 

机构地区：[1]太和医院循证医学与临床研究中心,湖北十堰442000 [2]宁夏医科大学,宁夏银川750004 [3]武汉大学人民医院临产室,湖北武汉430000

出　　处：《分子影像学杂志》2017年第4期430-435,共6页Journal of Molecular Imaging

摘　　要：目的系统评价雷珠单抗联合激光光凝对糖尿病黄斑水肿的疗效。方法计算机检索PubMed、EMbase、Cochrane Library、CBM、Wang Fang Data和CNKI数据库,搜索雷珠单抗联合激光光凝治疗糖尿病黄斑水肿的相关随机对照研究,检索时限均为从建库至2016年12月。由两位研究者独立筛选文献、提取资料,并评价纳入研究的偏倚风险后,采用RevMan 5.3软件进行Meta分析。结果共纳入7个随机对照研究,包含患者518例,眼数为556眼。Meta分析结果显示:联合组在1、3、6月最佳矫正视力的测量值均高于对照组,其差异均有统计学意义[SMD=-0.37,95%CI(0.05,0.69),P=0.02;SMD=1.17,95%CI(0.56,1.78),P=0.0002;SMD=2.34,95%CI(0.16,4.51),P=0.04],且随着时间的增加,联合组的视力恢复的更多,联合组在1、3、6月中央黄斑厚度的测量值较对照组明显减少,其差异均有统计学意义[SMD=-1.34,95%CI(-2.41,-0.28),P=0.01;SMD=-1.36,95%CI(-2.37,-0.34),P=0.009;SMD=-1.05,95%CI(-1.34,-0.76),P<0.00001]。结论雷珠单抗联合格栅光凝治疗治疗糖尿病黄斑水肿的效果优于单用雷珠单抗或格栅光凝,不良反应少,未见严重不良反应,值得在糖尿病黄斑水肿的治疗中应用和推广。Objective To systematically review the effect of ranibizumab joint laser photocoagulation on diabetic macular edema. Methods Databases including PubMed, EMbase, Cochrane Library, CBM, Wang Fang Data and CNKI were electronically searched to collect randomized controlled trials（RCTs） about the effect of ranibizumab joint laser photocoagulation in treatment of diabetic macular edema from inception to December 2016. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. The meta-analysis was performed through RevMan 5.3 software. Results A total of 7 RCTs involving 518 patients and 556 eyes were included. The results of meta- analysis showed that： BCVA measured values in joint group were higher than the control group on 1, 3, 6 months. The differences were significant [SMD=-0.37,95%CI（0.05, 0.69）, P=0.02; SMD=1.17, 95%CI（0.56, 1.78）, P=0.0002; SMD=2.34, 95% CI（0.16, 4.51）, P=0.04]. With the increase of time, the more visual acuity were on joint group. CMT measured values in joint group were significant less than the control group on 1, 3, 6 months [SMD=-1.34,95%CI （-2.41, -0.28）, P=0.01; SMD=-1.36, 95%CI （-2.37, -0.34）, P=0.009; SMD=-1.05, 95% CI （-1.34, -0.76）, P〈0.00001]. Conclusion Ranibizumab joint grid photocoagulation therapy for the treatment of diabetic macular edema than ranibizumab or grid photocoagulation, less adverse reaction and no serious adverse reactions. It is worth to apply grid photocoagulation and generalization in treatment of diabetic macular edema.

关 键 词：雷珠单抗 激光光凝 黄斑水肿 系统评价 随机对照试验 

分 类 号：R587.2[医药卫生—内分泌] R774.5[医药卫生—内科学]