鼠神经生长因子治疗NAION疗效及安全性的Meta分析  

A Meta-analysis of the Therapeutic Efficacy and Safety of Rat Nerve Growth Factor in Non-Arteritic Anterior Ischemic Optic Neuropathy

作　　者：王露露 张明明[1] 李书娇 邢凯 侯昕玥 亢泽峰[1] WANG Lulu;ZHANG Mingming;LI Shujiao;XING Kai;HOU Xinyue;KANG Zefeng(Eye Hospital,China Academy of Chinese Medical Sciences,Beijing 100040,China)

机构地区：[1]中国中医科学院眼科医院,北京100040

出　　处：《中国中医眼科杂志》2024年第3期284-290,共7页China Journal of Chinese Ophthalmology

基　　金：中医药传承与创新“百千万”人才工程(岐黄工程)岐黄学者;深圳市医疗卫生三名工程(SZSM201812090);北京市石景山区亢泽峰名医传承工作室项目;北京市石景山区医学重点专科项目。

摘　　要：目的对鼠神经生长因子(mNGF)治疗非动脉炎性前部缺血性视神经病变(NAION)的有效性和安全性进行Meta分析。方法检索PubMed、Web of Science、The Cochrane Library、中国知网、万方、维普和中国生物医学文献数据库建库至2023年2月报道的mNGF治疗NAION的随机对照试验(RCT),根据是否使用mNGF治疗分为治疗组和对照组。由2名研究者独立筛选文献、提取资料,评价纳入文献的偏倚风险,采用RevMan 5.3软件对总有效率、视力、视野、电生理P100峰潜时、视神经平均纤维层厚度进行Meta分析,并进行安全性评价。结果共纳入18篇文献,1,507例患者(1,573只眼),其中治疗组759例(797只眼),对照组748例(776只眼)。使用mNGF的治疗组总有效率[OR=4.810,95%CI(3.480,6.650),Z=9.540,P=0.000]、视力[MD=0.120,95%CI(0.080,0.170),Z=5.430,P=0.000]、视野平均缺损度[MD=-1.960,95%CI(-2.560,-1.360),Z=6.400,P=0.000]、电生理P100峰潜时[MD=-8.650,95%CI(-11.610,-5.700),Z=5.740,P=0.000]、视神经平均纤维层厚度[MD=10.420,95%CI(8.300,12.540),Z=9.650,P=0.000]均优于对照组,差异均有统计学意义。不良反应主要为局部注射mNGF后出现的局部刺激、疼痛、硬结,症状较轻。结论MNGF治疗NAION具有一定的疗效,可提高患者总有效率、视力,降低视野平均缺损度和视神经平均纤维层厚度,临床应用安全可靠。OBJECTIVE To conduct a Meta-analysis on the efficacy and safety of rat nerve growth factor(mNGF)in the treatment of non-arteritic anterior ischemic optic neuropathy(NAION).METHODS Randomized controlled trial(RCT)reporting the use of mNGF in treating NAION were retrieved from PubMed,Web of Science,The Cochrane Library,China National Knowledge Infrastructure(CNKI),Wanfang,VIP,and China Biology Medicine Database(CBM)databases up to February 2023.The studies were categorized into treatment and control groups based on the use of mNGF.Two researchers independently screened literature,extracted data,assessed the risk of bias in the included studies,and conducted a Meta-analysis using RevMan 5.3 software on the overall effective rate,visual acuity,visual field,electro-physiological P100 peak latency,and average thickness of the optic nerve fiber layer.Safety was also evaluated.RESULTS A total of 18 articles with 1,507 patients(1,573 eyes)were included,comprising 759 cases(797 eyes)in the treatment group and 748 cases(776 eyes)in the control group.The treatment group,using mNGF,showed significantly higher overall effective rate[OR=4.810,95%CI(3.480,6.650),Z=9.540,P=0.000],visual acuity[MD=0.120,95%CI(0.080,0.170),Z=5.430,P=0.000],average visual field defect degree[MD=-1.960,95%CI(-2.560,-1.360),Z=6.400,P=0.000],electro-physiological P100 peak latency[MD=-8.650,95%CI(-11.610,-5.700),Z=5.740,P=0.000],and average thickness of the optic nerve fiber layer[MD=10.420,95%CI(8.300,12.540),Z=9.650,P=0.000]compared to the control group,with statistically significant differences.Adverse reactions were primarily mild local stimulation,pain,and induration following local mNGF injection.CONCLUSIONS The mNGF treatment for NAION demonstrates certain efficacy,improving the overall effective rate,visual acuity,and reducing the average visual field defect degree and average thickness of the optic nerve fiber layer.Its clinical application is deemed safe and reliable.

关 键 词：非动脉炎性前部缺血性视神经病变 鼠神经生长因子 视力 随机对照试验 

分 类 号：R774.6[医药卫生—眼科]