摘要
目的:评价普罗布考(Probucol)及阿托伐他汀(Atorvastatin)治疗糖尿病性黄斑水肿(diabetic macular edema,DME)的疗效差异性。方法:通过检索1999-01/2014-01美国国立医学图书馆生物医学信息检索系统(PubMed)、英国医学会电子全文期刊数据库(BMA)、荷兰医学文摘数据库(EMbase)、学术期刊集成全文数据库(ASP)、考克兰图书馆(The Cochrane Library)、西文生物医学期刊文献数据库(EMCC)、中国生物医学文献数据库(CBM)、中国学术期刊全文数据库(CNKI)、万方数据库(CECDB)、维普中文科技期刊全文数据库(CQVIP)、中文科技期刊数据库(VIP)等数据库内相关的随机对照试验(RCT),对纳入文献的质量进行严格评价和资料提取,使用Stata/SE version 12.0软件对纳入研究进行系统评价。结果:最终纳入8个RCT,共309例患者,其中152例使用普罗布考、157例使用阿托伐他汀。系统评价结果显示:相比使用阿托伐他汀,使用普罗布考治疗的DME患者,黄斑区(Macula)水肿消退的人数显著增加[OR=1.75,95%CI(1.02,3.01)]、经治疗90d后尿8-羟基脱氧鸟苷(urinary 8-hydroxy deoxyguanosine)含量显著降低[SMD=-0.52,95%CI(-0.92,-0.12)];但系统评价同时提示:两药对于黄斑区硬性渗出的发生率未见显著差异性[OR=0.80,95%CI=(0.41,1.57)]、经治疗30d后尿8-羟基脱氧鸟苷含量未见显著差异性[SMD=-0.17,95%CI(-1.02,0.68)]。结论:使用普罗布考能有效抗脂质过氧化(Lipid peroxidation)、抑制泡沫细胞(Foam cells)在视网膜(Retinal)内沉积,从而改善症状。相比阿托伐他汀,使用普罗布考治疗DME具有更好的临床疗效。
AIM：To assess the efficacy differences of probucol and atorvastatin for the treatment of diabetic macular edema.METHODS： By searching the RCT, Pubmed, BMA, EMbase, ASP, The Cochrane Library, EMCC, CBM, CNKI, CECDB, CQVIP, VIP database from January 1999 to January 2014, strict appraisal and data extraction on the quality of the included studies, using Stata/SE version 12.0 software was used for statistical analysis. RESULTS. Eight RCTS, a total of 309 patients, were included, in which 152 cases usingprobucol, 157 cases using atorvastatin. The results showed that compared with atorvastatin group, the number of macular edema patients using probucol with DME was significantly increased[ OR= 1.75, 95%C/= （1.02, 3.01）1, after 90d, urinary 8-hydroxy deoxyguanosine significantly decreased ESMD= -0. 52, 95% CI= （-0.92, -0.12） but system evaluation also showed that= the differences of the two medicines on macular hard exudates were not statistically significant [OR= 0.80, 95% CI= （0.41, 1. 57）1, after treatment for 30d, the content of urinary 8- hydroxy deoxyguanosine between two groups had no significant difference[ SMD= -0.17, 95% CI= （ -1.02, 0.68）. CONCLUSION. Theprobucol can effectively restrain the production of lipid peroxidation, inhibit the foam cells deposition in the retina, thereby improving the symptoms. Compared with atorvastatin, the treatment of DME using probucol has better clinically effect.
出处
《国际眼科杂志》
CAS
2014年第11期2047-2053,共7页
International Eye Science
