全身应用皮质类固醇类药物对缺血性视神经病变影响的meta分析

发布时间：2018-03-08 17:29

本文选题：皮质类固醇类药物　切入点：缺血性视神经病变　出处：《吉林大学》2011年硕士论文　论文类型：学位论文

【摘要】：目的：评价全身应用皮质类固醇类药物对缺血性视神经病变(ischemic optic neuropathy, ION)的治疗作用。方法：不受发表状态和盲法的限制,以适当的检索式在Cochrane对照试验注册资料库、Ovid-medline全文数据库(1950-2011.1)、中国生物医学文献数据库(CBMdisc,1950-2011.1)、Embase数据库(1950-2011.1)、CNKI数据库(1950-2011.1)进行机检,对相关学术会议论文汇编和纸质眼科杂志等进行手检,并查阅相关的综述性文章,对其参考引用的相关文献资料进行进一步检阅,全面收集全身应用皮质类固醇类药物治疗缺血性视神经病变的临床随机对照试验(randomized controlled trial, RCT)、半随机对照试验、临床对照试验(controlled clinical trial, CCT)或者队列研究(Cohort study)的文献,根据Jadad评分量表的标准进行质量评价,并进行数据资料的提取,应用Reviewmanager 5.0软件包对视力、视野与缺血性视神经病变合并统计量进行定量综合分析、异质性检验、合并统计量检验,并评价发表偏倚,对分析结果做敏感性分析。结果：在检索到的929篇可能相关的中文及外文文献中,有6篇文章符合严格的纳入标准,最终被纳入研究。治疗效果合并分析结果显示,各指标所纳入文献资料之间均具有同质性(P0.05,I250%),使用固定效应模型；敏感性分析结果显示,各项指标敏感性分析结果均无差别,提示结果稳定；发表偏倚分析结果显示,各项指标漏斗图都略显不对称,尤其是全身应用皮质类固醇类药物治疗ION患者视野组仅有两项文献纳入,提示各项指标可能存在发表偏倚；合并结果显示,与对照组相比,全身应用皮质类固醇类药物组患者：①ION视力改善合并OR：1.75,95%CI[1.22,2.51],有统计学意义。②Non-arteritic ION视力改善合并OR：2.22,95%CI[1.46,3.38],有统计学意义。③ION视野改善OR：1.93,95%CI[1.23,3.02],有统计学意义。与对照组相比,口服泼尼松组患者：ION视力改善合并OR：2.24,95%CI[1.47,3.42],有统计学意义。结论：全身应用皮质类固醇类药物对非动脉炎性缺血性视神经病变、缺血性视神经病变视力的改善均有良好的控制作用。口服泼尼松对缺血性视神经病变视力的改善有良好的控制作用。全身应用皮质类固醇类药物对缺血性视神经病变患者视野的改善有良好的控制作用。但是我们仍需要开展一系列更高质量的研究来证实。
[Abstract]:Aim: to evaluate the therapeutic effect of corticosteroids on ischemic optic neuropathyin ischemic optic neuropathy (ION). Methods: without the limitation of publication status and blind method, the full text database of Ovid-medline and the Chinese biomedical literature database were checked by appropriate retrieval method in Cochrane controlled trial database (1950-2011) and Embase database (1950-2011 / 1). To carry on the hand examination to the related academic conference paper compilation and the paper ophthalmology magazine, and to consult the related summary article, carries on the further review to its reference citation related literature material, The literature of randomized controlled controlled trial, controlled clinical trial, semi-randomized controlled trial, cohort study or cohort study on ischemic optic neuropathy treated with corticosteroid drugs were collected. According to the standard of Jadad score scale, the quality evaluation was carried out, and the data was extracted. The combined statistics of visual acuity, visual field and ischemic optic neuropathy were analyzed by Reviewmanager 5.0 software package, and the heterogeneity test was used to test the heterogeneity of visual acuity, visual field and ischemic optic neuropathy. Statistical test was combined and publication bias was evaluated. Sensitivity analysis of the results was made. Results: of the 929 Chinese and foreign literatures that might be relevant, 6 articles met the strict inclusion criteria and were eventually included in the study. The results of sensitivity analysis showed that the results of sensitivity analysis showed that the results of sensitivity analysis showed that the results of sensitivity analysis were stable, and the results of published bias analysis showed that, The funnel graph showed a slight asymmetry, especially in the visual field group of patients with ION treated with corticosteroid drugs. Only two articles were included in the study group, indicating that the indicators might have a bias of publication, and the combined results showed that, compared with the control group, there was a significant difference between the two groups. In the whole body corticosteroid drug group, the visual acuity of the patients with 1: 1 ion + OR1.75 + 95CI [1.222.51], the visual acuity improvement of non-arteritic ION with OR: 2.222.995 CI [1.463.38], the visual field improvement of OR-1.9395CI [1.233.02] were statistically significant compared with those of the control group. In oral prednisone group, the visual acuity was improved with OR: 2.24 + 95 + CI [1.47 卤3.42], which was statistically significant. Conclusion: corticosteroids are used in the treatment of non-arterial inflammatory ischemic optic neuropathy. The improvement of visual acuity of ischemic optic neuropathy was well controlled. Oral prednisone had a good control effect on the improvement of visual acuity of ischemic optic neuropathy. Systemic application of corticosteroids on ischemic optic nerve. The improvement of visual field in patients with disease is well controlled, but we still need to do a series of higher quality studies to confirm it.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R774.6

【引证文献】