抗VEGF与激光治疗1型早产儿视网膜病变的Meta分析  

Anti-VEGF and laser therapy for type 1 retinopathy of prematurity:a Meta analysis

作　　者：熊期[1] 张超 蔡小军[1] 余爱华[1] 柯敏[1] Qi Xiong;Chao Zhang;Xiao-Jun Cai;Ai-Hua Yu;Min Ke(Department of Ophthalmology, Zhongnan Hospital, Wuhan University, Wuhan 430071, Hubei Province, China;Department of Evidence-Based Medicine Center, Taihe Hospital, Affiliated Taihe Hospital of Hubei University of Medicine, Shiyan 442000, Hubei Province, China)

机构地区：[1]武汉大学中南医院眼科,中国湖北省武汉市430071 [2]中国湖北省十堰市太和医院(湖北医药学院附属医院)循证医学中心,442000

出　　处：《国际眼科杂志》2021年第2期285-290,共6页International Eye Science

摘　　要：目的:系统评价抗VEGF与激光治疗1型早产儿视网膜病变(ROP)的疗效分析。方法:通过计算机检索PubMed、EMbase、CBM、The Cochrane Library、WanFang Data、CNKI和VIP数据库,收集比较抗VEGF与激光用于治疗1型ROP疗效的随机对照试验(RCT),检索时限均从建库至2020-01-06,按照纳入与排除标准提取资料,行质量评价后,采用RevMan 5.3软件进行Meta分析。结果:共纳入6个RCT。Meta分析结果显示:抗VEGF与激光组相比,复发率无差异[RR=0.94,95%CI(0.17~5.23),P=0.94];亚组分析Ⅰ区有差异[RR=0.17,95%CI(0.05~0.62),P=0.007];Ⅱ区无差异[RR=2.20,95%CI(0.07~73.48),P=0.66]。与激光组相比,再治疗率无差异[RR=2.36,95%CI(0.70~7.99),P=0.17],亚组分析Ⅰ区无差异[RR=0.33,95%CI(0.01~7.50),P=0.49];Ⅱ区有差异[RR=13,95%CI(1.84~92.01),P=0.01]。两者不良反应发生率无差异[RR=0.87,95%CI(0.54~1.40),P=0.57]。结论:激光和抗VEGF疗效相当,但在降低Ⅰ区复发率方面抗VEGF则更有优势,降低Ⅱ区再治疗率方面激光更有优势。AIM:To systematically evaluate the effect of anti-VEGF and laser treatment on type 1 retinopathy of prematurity(ROP).METHODS:Randomized controlled trials(RCTs)comparing the efficacy of anti-VEGF and laser therapy for type 1 ROP were retrieved from PubMed,EMbase,CBM,The Cochrane Library,WanFang Data,CNKI and VIP databases.The search time was from the establishment of the databases to January 2020.The data were extracted according to the inclusion and exclusion criteria.After quality evaluation,then Meta-analysis was made by Revman 5.3 software.RESULTS:A total of 6 RCTs were included.The results of Meta-analysis showed that:there was no statistical difference in the recurrence incidence between anti-VEGF group and laser group[RR=0.94,95%CI(0.17-5.23),P=0.94];subgroup analysis revealed a statistical significant in zoneⅠ[RR=0.17,95%CI(0.05-0.62),P=0.007],while zone II has no statistical significant[RR=2.20,95%CI(0.07-73.48),P=0.66].Compared with the laser group,the retreatment rate[RR=2.36,95%CI(0.70-7.99),P=0.17]was statistical significant;There was no significant difference in subgroup analysis of zoneⅠ[RR=0.33,95%CI(0.01-7.50),P=0.49],while the difference in zoneⅡ[RR=13,95%CI(1.84-92.01),P=0.01]was statistically significant.There was no significant difference in the incidence of adverse reactions between the two groups[RR=0.87,95%CI(0.54-1.40),P=0.57].CONCLUSION:Laser and anti-VEGF treatment are equally effective.Anti-VEGF has less recurrence rate in zoneⅠwhile laser is more effective in the retreatment rate in zoneⅡ.

关 键 词：抗VEGF 激光 早产儿视网膜病变 META分析 系统评价 随机对照试验 

分 类 号：R73[医药卫生—肿瘤]