强化血糖控制对2型糖尿病患者眼部并发症影响的Meta分析  

Meta-analysis of the effect of intensive glycemic control on ocular complications in patients with type 2 diabetes

作　　者：李欢欢 王素华 姚春莲 王佩 欧秋果 谢晶 Li Huan-huan;Wang Su-hua;Yao Chun-lian;Wang Pei;Ou Qiu-guo;Xie Jing(Department of Ophthalmology,The First Hospital Affiliated to Army Medical University,Chongqing 400038,China)

机构地区：[1]陆军军医大学第一附属医院眼科,重庆400038

出　　处：《兰州大学学报（医学版）》2020年第5期15-20,27,共7页Journal of Lanzhou University（Medical Sciences）

基　　金：重庆市社会科学规划青年项目(JX6C-25)。

摘　　要：目的评价强化血糖控制对2型糖尿病患者眼部并发症的影响。方法检索PubMed、Embase、Cochrane Library、中国知识基础设施工程等数据库,搜集强化血糖控制对2型糖尿病患者眼部并发症影响的随机对照试验,时间限定为建库至2019年3月。用RevMan5.3进行Meta分析。结果纳入7篇文献。Meta分析结果显示:强化血糖控制能降低2型糖尿病患者的糖尿病视网膜病变进展率(OR=0.65,95%CI:[0.43,0.98],P=0.04)、黄斑水肿发生率(OR=0.65,95%CI:[0.43,0.98],P=0.04)、玻璃体切除率(OR=0.75,95%CI:[0.63,0.90],P=0.002)及白内障手术率(OR=0.88,95%CI:[0.80,0.98],P=0.01);但在糖尿病视网膜病变率(OR=0.67,95%CI:[0.26,1.73],P=0.40)及中度以上视力丧失率方面(OR=0.99,95%CI:[0.86,1.13],P=0.85),强化血糖控制与标准血糖控制差异无统计学意义(P>0.05)。结论强化血糖控制能降低2型糖尿病患者的糖尿病视网膜病变进展率、黄斑水肿发生率、玻璃体切除率等并发症。Objective To evaluate the effect of intensive glycemic control on ocular complications in patients with type 2 diabetes.Methods PubMed,Embase,Cochrane Library,China National Knowledge Infrastructure,etc.were searched to collect randomized controlled trials of the effect of intensive glycemic control on ocular complications in patients with type 2 diabetes.The time limit was from the establishment of the datebase to March 2019.RevMan5.3 was used to perform the Meta analysis.Results Seven articles were included.The results of the Meta analysis showed that intensive glycemic control could reduce the progression rate of diabetic retinopathy(OR=0.65,95%CI:[0.43,0.98],P=0.04),incidence of macular edema(OR=0.65,95%CI:[0.43,0.98],P=0.04),vitreous resection rate(OR=0.75,95%CI:[0.63,0.90],P=0.002)and cataract surgery rate(OR=0.88,95%CI:[0.80,0.98],P=0.01)in patients with type 2 diabetes.However,in terms of diabetic retinopathy rate(OR=0.67,95%CI:[0.26,1.73],P=0.40)and moderate or above visual acuity loss rate(OR=0.99,95%CI:[0.86,1.13],P=0.85),the difference between the enhanced and standard blood glucose control has no statistically significance(P>0.05).Conclusion Intensive glycemic control can reduce diabetic retinopathy progression rate,macular edema rate,vitrectomy rate and other complications in patients with type 2 diabetes.

关 键 词：强化血糖控制 2型糖尿病 眼部并发症 META分析 

分 类 号：R77[医药卫生—眼科]