前列腺素类药物治疗眼压升高患者的贝叶斯网状Meta分析  

Bayesian network Meta-Analysis of prostaglandins in treatment of patients with elevate intraocular pressure

作　　者：刘俊 董欣宜 LIU Jun;DONG Xinyi(Department of Pharmacy,Tianjin Second People's Hospital,Tianjin 300192,China;Department of Pharmacy,Tianjin Medical University Eye Hospital,Tianjin 300384,China)

机构地区：[1]天津市第二人民医院药剂科,天津300192 [2]天津医科大学眼科医院药剂科,天津300384

出　　处：《中国医院药学杂志》2023年第12期1378-1385,共8页Chinese Journal of Hospital Pharmacy

摘　　要：目的:系统评价前列腺素类药物在降低眼压方面的疗效及安全性。方法:计算机检索中国知网、CBM、万方、维普、PubMed、Cochrane Library等数据库,检索关于前列腺类药物治疗眼压升高患者的随机对照试验(randomized controlled trial, RCT),检索时限为建库至2022年4月。采用Cochrane推荐的偏倚风险评估工具对纳入RCT进行质量评价。应用RevMan 5.4、Stata 14、ADDIS软件进行贝叶斯网状Meta分析。结果:纳入25篇RCT,总样本量3 688例,研究时限为3个月,纳入4种前列腺类药物,拉坦前列素(latanoprost, LAT)、贝美前列素(bimatoprost, BIM)、曲伏前列素(travoprost, TRA)、他氟前列素(tafluprost, TAF)。有效性方面,降低眼压效果排序为BIM>TAF>LAT>TRA。结膜充血发生率排序为BIM>TRA>TAF>LAT。结论:根据本研究结果,对于病情严重患者,如能耐受结膜充血等局部副作用应用贝美前列素是最优选择,对于单纯高眼压症及轻度青光眼患者,应用他氟前列素和拉坦前列素即可获得稳定降眼压效果,且助于提高用药依从性。OBJECTIVE To systematically evaluate the efficacy and safety of prostatic drugs in reducing intraocular pressure.METHODS The CNKI,CBM,Wanfang,VIP,PubMed,Cochrane Library and other databases were electronically retrieved to gather randomized controlled trials(RCT)of prostatic drugs in treatment of patients with elevated intraocular pressure from their inception to Apr.2022.The quality of included RCT was evaluated using a Cochrane recommended bias risk assessment tool.Bayesian network Meta-analysis was performed by RevMan 5.4,STATA 14 and ADDIS.RESULTS 25 RCTs with a sample size of 3,688 were included,the study time was 3 months.A total of 4 prostatic drugs were included.including four prostaglandin drugs.They were lantanoprost(LAT),bimatoprost(BIM),travoprost(TRA)and tafluprost(TAF).In terms of effectiveness,the order of IOP reduction was BIM>TAF>LAT>TRA.Regarding the incidence of conjunctival hyperemia,the order was BIM>TRA>TAF>LAT.CONCLUSION According to the results of this study,for patients with severe conditions,the optimal choice is to tolerate local side effects such as conjunctival congestion.For patients with simple high intraocular pressure and mild glaucoma,the use of tafloprost and latanoprost can achieve stable intraocular pressure lowering effects and help improve medication compliance.

关 键 词：网状Meta分析 青光眼 拉坦前列素 贝美前列素 曲伏前列素 他氟前列素 

分 类 号：R96[医药卫生—药理学]