摘要
目的比较单纯黄斑区格栅样激光光凝（MLG）与玻璃体腔注射曲安奈德（IVTA）联合MLG治疗糖尿病黄斑水肿（DME）的有效性及安全性。方法计算机检索循证医学图书馆、荷兰医学文摘、生物医学数据库、中国生物医学文献数据库、中国期刊全文数据库及中文科技期刊全文数据库。收集IVTA联合MLG与MLG治疗DME临床随机对照试验（RCT），评价纳入研究的质量，提取有效数据，采用荟萃分析软件（RevMan）5．1进行meta分析。比较两种治疗方法对最佳矫正视力（BCVA）及黄斑中心凹厚度（CMT）的影响。结果共纳入6个RCT，共331只眼。其中，MLG组166只眼，IVTA联合MLG组165只眼。随访6个月时，IVTA联合MLG组与MLG组比较，BCVA差异无统计学意义（Z=1．27，P=0．20），但CMT差异有统计学意义（Z=2．41，P=0．02），眼压增高及白内障等并发症发生率差异有统计学意义（Z=3．62，P〈O．01）。结论IVTA联合MLG治疗DME可降低CMT，但在改善视功能方面与MLG比较无明显优势。这仍需要高质量的、大样本的RCT数据进一步论证。
Objective To evaluate the efficacy and safety of intravitreal triamcinolone acetomde combined of macular laser grid photocoagulation （IVTA/MLG） versus macular laser grid （MLG） photocoagulation only for treatment of diabetic maeular edema. Methods A computerized search was conducted in the Cochrane Library, Embase Library, Pubmed, Chinese Biomedical Database, Chinese Journal Full-text Database and Chinese Science and Technology Periodicals Database. Randomized controlled trials （RCT） on IVTA/MLG and MLG only for treatment of diabetic macular edema were selected. After the data extraction, quality of RCT was assessed. The meta analysis was performed by RevMan 5.1. The outcome measures included best-corrected visual acuity （BCVA） and the central foveal thickness （CMT）. Results In total, six RCT that fulfilled the eligibility criteria were included in the recta-analysis involving 166 eyes in MLG group and 165 eyes in IVTA/MLG group. The results suggested that there was no significant differences in BCVA （Z =1.27, P = 0.20）, but differences were statistically significant comparing CMT （Z=2.41, P=0.02）, incidence of ocular hypertension and cataract （Z=3.62, P〈0.01） between MLG and IVTA/MLG groups at the six month follow-up. Conclusions There is no significant advantage of IVTA/MLG as compared with MLG, but it could reduce CMT. However, a high-quality, large sample RCT should be further investigated.
出处
《中华眼底病杂志》
CAS
CSCD
北大核心
2012年第6期621-624,共4页
Chinese Journal of Ocular Fundus Diseases
关键词
曲安奈德
治疗应用
激光凝固术
治疗应用
黄斑水肿
治疗
META分析
Triamcinolone acetonide/therapeutic uses
Laser coagulation/therapeutic uses l Macula edema/therapy~ Meta-analysis
