玻璃体腔注射贝伐单抗与维替泊芬光动力疗法治疗年龄相关性黄斑变性患者脉络膜新生血管的系统评价

发布时间：2019-05-07 22:36

【摘要】：目的:玻璃体腔注射贝伐单抗与维替泊芬光动力疗法治疗AMD患者进行系统评价。方法:按照Cochrane系统评价方法,计算机检索MEDLINE(1966-2009.12)、EMbase(1980-2009.12)、Cochrane图书馆(2009年3期)和中国生物医学文献数据库(1979-2009.12),并手工检索相关会议文献。文献语种限制为中、英文。收集所有相关随机对照试验,采用Cochrane协作网提供的RevMan5.0软件进行Meta分析,以获得玻璃体腔注射贝伐单抗与维替泊芬光动力疗法治疗AMD患者的相关证据。结果:经过全面检索及筛查后,共纳入2篇随机对照试验,共计229例患者,Meta分析结果显示:在AMD患者中,采用贝伐单抗治疗AMD CNV患者较PDT治疗能提高最佳矫正视力(MD,0.09;95%CI,0.06to0.13;P0.00001),使视力明显改善(最佳矫正视力能提高2行)[RR=2.98,95%CI(1.28,6.92)]并使最佳矫正视力能提高3行(RR=1.36;95%CI,1.09to 1.69;P=0.007),但单独使用PDT治疗较单独使用伐单抗治疗可以使中心凹厚度减少更明显(MD,16.50;95%CI,3.56to29.44; P=0.01)。结论:在AMD患者中,采用贝伐单抗治疗AMD CNV患者较PDT治疗能提高最佳矫正视力,使视力明显改善(最佳矫正视力能提高2行甚至3行),但PDT治疗在减少中心凹厚度程度方面更明显。但两种治疗方法与是否需要联合治疗,治疗频率以及最大线性测量等指标的关系,以及经济学评价有待于进一步研究。因本系统评价纳入研究病例数较少,上述结论尚需更多设计严谨的大样本随机对照试验加以验证。
[Abstract]:Objective: to evaluate the efficacy of intravitreal injection of bevacumab and Vitopol in the treatment of AMD. Methods: according to the method of Cochrane system evaluation, a computer search was conducted in MEDLINE (1966b / 2009.12 /), EMbase (1980 / 2009.12 /), Cochrane Library (issue 3 / 2009) and Chinese Biomedical Literature Database (1979b / 2009.12). The related documents were searched by hand. The language of the literature is limited to Chinese and English. All relevant randomized controlled trials were collected and Meta analysis was carried out with RevMan5.0 software provided by Cochrane Collaborative Network to obtain evidence of vitreous injection of bevacizumab and viticophane photodynamic therapy for the treatment of AMD patients. Results: after comprehensive search and screening, a total of 2 randomized controlled trials were conducted in 2 patients. The results of Meta analysis showed that the best corrected visual acuity (MD,) of AMD CNV patients treated with bevacumab was higher than that of PDT. 0.09; 95% CI, 0.06 to 0.13 P0.00001), significantly improved visual acuity (best corrected visual acuity increased by 2 lines) [RR=2.98,95%CI (1.28, 6.92)] and improved best corrected visual acuity by 3 lines (RR=1.36;) 95% CI, 1.09 to 1.69p / 0.007), but the thickness of fovea was significantly decreased by PDT alone (MD,16.50;95%CI,3.56to29.44; P0. 01). Conclusion: in patients with AMD, the best corrected visual acuity and visual acuity can be improved significantly in patients with AMD CNV treated with bevacumab compared with PDT (the best corrected visual acuity can be improved by 2 lines or even 3 lines). However, PDT treatment was more obvious in reducing the thickness of the fovea. However, the relationship between the two treatment methods and the need for combined therapy, the frequency of treatment and the maximum linear measurement, as well as the economic evaluation, need to be further studied. Due to the small number of cases included in the system evaluation, more well-designed large sample randomized controlled trials are needed to verify the above conclusions.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R774.5

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