抗VEGF药物治疗糖尿病视网膜微血管瘤的Meta分析  

Meta-analysis on diabetic retinal microaneurysms managed by anti-vascular endo⁃thelial growth factor agents

作　　者：马继贤 李晶明[1] 刘秋平[1] MA Jixian;LI Jingming;LIU Qiuping(Affiliated Eye Hospital of Nanchang University,Nanchang 330006,China)

机构地区：[1]南昌大学附属眼科医院,南昌330006

出　　处：《中国中医眼科杂志》2023年第1期88-94,共7页China Journal of Chinese Ophthalmology

基　　金：国家自然科学基金项目(81960177);江西省自然科学基金项目(20192BAB205049)。

摘　　要：目的通过Meta分析探究玻璃体腔注射抗血管内皮生长因子(VEGF)药物治疗糖尿病视网膜微血管瘤的作用。方法检索PubMed、Cochrane Library、Embase、Web of Science等数据库建库至2020年12月31日关于使用抗VEGF药物玻璃体腔注射治疗糖尿病视网膜病变(DR)的文献,使用RevMan5.3软件、Stata15.1软件进行Meta分析。结果共纳入9项研究,包括375例患者(413只眼)。与治疗前比较,DR患者玻璃体腔注射抗VEGF药物后视网膜微血管瘤数量减少,差异有统计学意义[SMD=-1.11,95%CI(-1.59,-0.63),Z=4.530,P=0.000]。对9项研究进行亚组分析,结果显示不同的抗VEGF药物(总体异质性:P=0.000,I^(2)=88.8%;阿柏西普亚组异质性:P=0.560,I^(2)=0.0%)和不同的微血管瘤计数方式(总体异质性:P=0.000,I^(2)=90.1%;荧光素血管造影亚组异质性:P=0.370,I^(2)=0.0%)是导致异质性的来源;但根据注药频率、检测时间、不同人种进行亚组分析时,组间差异均无统计学意义(P>0.05),尚不能认为上述因素是异质性来源。结论玻璃体腔注射抗VEGF药物能减少DR患者视网膜的微血管瘤数量,并且微血管瘤数量减少程度与抗VEGF药物的种类及计数方式相关。OBJECTIVE To explore the effect of intravitreal anti-vascular endothelial growth factor(VEGF)agents on diabetic retinal microaneurysms by Meta-analysis.METHODS Literature on intravitreal injection of anti-VEGF agents for diabetic retinopathy were retrieved from PubMed,Cochrane Library,Embase,Web of Science.The search period was from the establishment of each database to December 31,2020.RevMan5.3 software and Stata15.1 software were used for Meta-analysis of the retrieved documents.RESULTS A total of nine papers were included,including of 375 patients(413 eyes).Compared with result before treatment,the number of retinal microaneurysms in DR patients decreased after intravitreal injection of anti-VEGF agents,with a statistically significant difference[SMD=-1.11,95%CI(-1.59,-0.63),Z=4.530,P=0.000].Moreover,when subgroup analysis was performed,the result showed that different antiVEGF agents(totally:P=0.000,I^(2)=88.8%,and the subgroup of Aflibercept:P=0.560,I^(2)=0.0%)and microaneurysms count strategy(totally:P=0.000,I^(2)=90.1%,the subgroup of fluorescein angiography:P=0.370,I^(2)=0.0%)were the sources of heterogeneity.However,if subgroup analysis was performed according to the agent's injection frequency and imaging time point and different races,there was no significant difference between the groups(P>0.05),suggesting that these group factors cannot be considered as source of heterogeneity.CONCLUSIONS Anti-VEGF therapy may reduce the number of retinal microaneurysms in the patients with diabetic retinopathy,and the decrease in the number of microaneurysms was related to the type of antiVEGF agents and microaneurysms count strategy.

关 键 词：抗血管内皮生长因子 糖尿病视网膜病变 微血管瘤 糖尿病 META分析 

分 类 号：R774.1[医药卫生—眼科]