玻璃体腔注射雷珠单抗对比曲安奈德治疗糖尿病性黄斑水肿的Meta分析

Intravitreal Injection of Triamcinolone Acetonide Versus Ranibizumab in the Treatment of Diabetic Macular Edema: A Meta-analysis

关键词:  雷珠单抗  曲安奈德  糖尿病性黄斑水肿  meta分析

Key words:  ranibizumab  triamcinolone acetonid  diabetic macular edema  meta-analysis

摘要:

目的 通过系统评价比较雷珠单抗和曲安奈德治疗糖尿病性黄斑水肿的相关文献，为临床指导用药提供依据。方法在美国国立医学图书馆Pubmed数据库、Cochrane数据库及万方数据库、中国知网、中国生物医学文献数据库（CBM）、维普数据库中检索有关玻璃体腔注射雷珠单抗和曲安奈德的临床随机对照试验文献，并对纳入文献进行风险评估，提取文献中相关指标采用Revman 5.3软件进行meta分析，同时绘制漏斗型图对发表偏倚进行检测。结果 共纳入符合条件文献13篇，合计579例患者，其中黄斑中心凹视网膜厚度[WMD=-7.56，95% CI （-18.07，2.94），P=0.16]，最佳矫正视力[WMD=0.04，95% CI （0.03，0.06），P<0.000 01]，眼压[WMD=-2.88，95% CI （-3.61，-2.15），P<0.000 01]。结论 Meta分析结果显示，2组患眼用药干预后，发现雷珠单抗干预在最佳矫正视力和眼压值上均优于曲安奈德，差异有统计学意义。而在改善黄斑中心凹视网膜厚度上两者差异不显著。

Abstract:

OBJECTIVE To provide the basis for clinical guidance of diabetic macular edema(DME) drugs by compare the efficacy of ranibizumab and triamcinolone acetonide against DME use systematic review.METHODS Relevant randomized control trials about ranibizumab vesus triamcinolone acetonid were identified by searching electronic databases including Pubmed, Cochrane Library, Wanfang data, CNKI, CBM and VIP. The risk of extracted literatures were assessed, meta-analyses of relevant index were performed using RevMan 5.3 software, funnel plots were also used to detect the publication bias.RESULTS A total of 13 studies, involving 579 patients were included. Results of meta-analysis showed that central macular of retinal thickness(CRT)[WMD=-7.56, 95%CI(-18.07, 2.94), P=0.16], best corrected visual acuity(BCVA)[WMD=0.04, 95%CI(0.03, 0.06), P<0.000 01], intra-ocular tension[WMD=-2.88, 95%CI(-3.61, -2.15), P<0.000 01].CONCLUSION Meta-analysis showes that the intervention with ranibizumab was better than that of triamcinolone acetonide on BCVA, CRT and intra-ocular pressure, the differences were significant.