糖皮质激素静脉冲击疗法与常规口服治疗在Graves眼病中应用的Meta分析

发布时间：2018-11-06 10:13

【摘要】：目的:评价糖皮质激素静脉冲击疗法与常规口服治疗应用于Graves眼病的临床有效性及安全性。方法:以计算机及手工检索国内外比较糖皮质激素静脉冲击疗法及常规口服治疗在Graves眼病患者中应用的随机对照研究(RCT),按照Cochrane系统评价方法,筛选文献、评价纳入文献质量,使用Revman5.2软件进行系统统计分析。结果:共检索到相关文献54篇,评价后纳入5项研究,共265例患者,其中糖皮质激素静脉冲击疗法组134例,常规口服治疗组131例。Meta分析研究结果显示:①临床效果:糖皮质激素静脉冲击治疗组较常规口服治疗组可有效改善患者临床活动度评分(WMD=0.82,95%CI:0.61~1.03,P0.001)、突眼度(WMD=0.62,95%CI:0.11~1.12,P=0.02)、眼裂宽度(WMD=0.72,95%CI:0.14~1.30,P=0.01),但两组在改善复视方面无明显统计学差异(OR=1.51,95%CI:0.77~2.95,P=0.23)。②安全性:静脉冲击疗法组较口服治疗组有较低的不良事件发生率(OR=0.16,95%CI:0.08~0.30,P0.001)。结论:与常规口服治疗组比较,静脉冲击疗法对Graves眼病具有更好的治疗效果,且安全性高。
[Abstract]:Objective: to evaluate the clinical efficacy and safety of glucocorticoid intravenous impulse therapy and routine oral therapy in Graves ophthalmopathy. Methods: a randomized controlled study of intravenous impulse therapy with glucocorticoid and routine oral therapy in patients with Graves ophthalmopathy was conducted by computer and manual retrieval. The literature was screened by (RCT), according to the Cochrane system evaluation method. The evaluation includes the quality of literature and makes systematic statistical analysis with Revman5.2 software. Results: a total of 54 literatures were retrieved, and 5 studies were included in the evaluation. 265 patients were included in the study, including 134 patients in the glucocorticoid intravenous impulse therapy group, and 134 patients in the glucocorticoid intravenous impulse therapy group. The results of Meta analysis showed that: 1 Clinical effect: glucocorticoid intravenous impulse therapy group can effectively improve the clinical activity score (WMD=0.82,95%CI:0.61~1.03,) of patients compared with the routine oral treatment group. (P0.001), exophthalmos (WMD=0.62,95%CI:0.11~1.12,P=0.02), fissure width (WMD=0.72,95%CI:0.14~1.30,P=0.01), But there was no significant difference between the two groups in improving diplopia (OR=1.51,95%CI:0.77~2.95,). 2 Safety: the incidence of adverse events (OR=0.16,95%CI:0.08~0.30,P0.001) in the intravenous impulse therapy group was lower than that in the oral treatment group. Conclusion: compared with the routine oral treatment group, intravenous shock therapy is more effective and safe in the treatment of Graves ophthalmopathy.
【作者单位】：南京医科大学附属无锡第二人民医院老年医学科;
【分类号】：R771.3

【参考文献】