血管内皮生长因子抑制剂治疗早产儿视网膜病变有效性和安全性的Meta分析  

Meta-analysis of the Efficacy and Safety of Anti-vascular Endothelial Growth Factor Inhibitor in the Treatment of Retinopathy of Prematurity

作　　者：胡志强[1,2,3,4] 张伶俐[1,2,3,4] 李佳莲[1,2,3,4] 张祚洁 曾力楠[2,3,4] 石晶[5] 全淑燕 HU Zhiqiang;ZHANG Lingli;LI Jialian;ZHANG Zuojie;ZENG Li’nan;SHI Jing;QUAN Shuyan(West China School of Pharmacy,Sichuan University,Chengdu 610041,China;Dept. of Pharmacy,West China Second University Hospital,Sichuan University,Chengdu 610041,China;Evidence-Based Pharmacy Center,West China Second University Hospital,Sichuan University,Chengdu 610041,China;Key Laboratory of Birth Defects and Related Diseases of Women and Children,Ministry of Education,Chengdu 610041,China;Dept. of Pediatric Teaching and Research Office,West China Second University Hospital,Sichuan University,Chengdu 610041,China)

机构地区：[1]四川大学华西药学院,成都610041 [2]四川大学华西第二医院药学部,成都610041 [3]四川大学华西第二医院循证药学中心,成都610041 [4]出生缺陷与相关妇儿疾病教育部重点实验室,成都610041 [5]四川大学华西第二医院儿科教研室,成都610041

出　　处：《中国药房》2016年第24期3377-3379,共3页China Pharmacy

基　　金：国家自然科学基金资助项目(No.813773381)

摘　　要：目的:系统评价血管内皮生长因子(VEGF)抑制剂治疗早产儿视网膜病变(ROP)的有效性和安全性,为临床提供循证参考。方法:计算机检索Pub Med、EMBase、Cochrane图书馆、中国期刊全文数据库、中文科技期刊数据库、中国生物医学文献数据库和万方数据库,收集VEGF抑制剂(试验组)对比激光光凝治疗(对照组)治疗ROP的随机对照试验(RCT),对符合标准的研究进行资料提取,并用Cochrane系统评价员手册5.1.0进行质量评价后,采用Rev Man 5.1统计软件进行Meta分析。结果:共纳入5项RCT,合计381例患儿,754只眼睛。Meta分析结果显示,试验组患儿ROP复发率[RR=0.23,95%CI(0.13,0.42),P<0.001]、视网膜脱离率[RR=0.27,95%CI(0.14,0.51),P<0.001]、附加病变消退时间[MD=-1.31,95%CI(-1.47,-1.14),P<0.001]均显著低于对照组,差异均有统计学意义;两组患儿屈光不正、不良反应发生率比较差异无统计学意义(P>0.05)。结论:玻璃体腔注射VEGF抑制剂治疗ROP疗效优于激光光凝治疗,但其最佳给药剂量、安全性尚待大样本、设计良好的RCT进一步验证。OBJECTIVE:To systematically review the efficacy and safety of anti-vascular endothelial growth factor(VEGF)inhibitorsin the treatment of retinopathy of prematurity(ROP),and provide evidence-based reference for clinic. METHODS:Retrievedfrom PubMed,EMBase,Cochrane Library,CJFD,VIP,CBM and Wangfang Database,randomized controlled trials(RCT)about VEGF inhibitors(test group)versus laser photocoagulation treatment(control group)in the treatment of ROP werecollected. Meta-analysis was performed by using Rev Man 5.1 software after data extraction and quality evaluation by Cochrane reviewersmanual 5.1.0. RESULTS:Totally 5 RCTs were included,involving 381 infants and 754 eyes.Results of Meta-analysisshowed that the recurrence rate of ROP [RR=0.23,95%CI(0.13,0.42),P<0.001],retinal detachment incidence [RR=0.27,95%CI(0.14,0.51),P<0.001] andresolution of plus signs [MD=-1.31,95%CI(-1.47,-1.14),P<0.001] in test group were significantlylower than control group,the differences were statistically significant;and there was no significant difference in the refractiveerrors and the incidence of adverse reactions in 2 groups(P>0.05). CONCLUSIONS:Intravitreal VEGF inhibitors have betterefficacy than laser photocoagulation in the treatment of ROP,but the optimal dose and safety need further verification by large-sampleand well-designed RCT.

关 键 词：早产儿视网膜病变 血管内皮生长因子抑制剂 META分析 

分 类 号：R744.1[医药卫生—神经病学与精神病学]