【摘 要】
：
目的 本文系统评价了玻璃体内注射(VEGF)药物治疗糖尿病性黄斑水肿的有效性和安全性.方法 以抗血管内皮因子,糖尿病黄斑水肿,为关键词,在pubmed,EMBASE,Cochrane图书馆等进行文献检索,检索到文献762篇,按照文献等级等检索到的文献进行分类,纳入随机对照研究进行荟萃分析,以评价玻璃体内注射抗VEGF药物在减轻糖尿病性黄斑水肿和改善视力方面的作用效果总结并评价了上述治疗)的不良事件
【机 构】
：
山东中医药大学附属眼科医院 山东中医药大学第二附属医院
【出 处】
：
第八届亚洲神经眼科大会暨第四届全国神经眼科学术会议
论文部分内容阅读
目的 本文系统评价了玻璃体内注射(VEGF)药物治疗糖尿病性黄斑水肿的有效性和安全性.方法 以抗血管内皮因子,糖尿病黄斑水肿,为关键词,在pubmed,EMBASE,Cochrane图书馆等进行文献检索,检索到文献762篇,按照文献等级等检索到的文献进行分类,纳入随机对照研究进行荟萃分析,以评价玻璃体内注射抗VEGF药物在减轻糖尿病性黄斑水肿和改善视力方面的作用效果总结并评价了上述治疗)的不良事件.结果 本研究共纳入7个RCT,总计患眼1653只.将其中5篇雷珠单抗玻璃体内注药RCT研究进行荟萃分析.研究发现,抗VEFG药物注射较假注射组,明显改善患者视力(OR=3.65,95％ CI：2.67-4.71,Z=8.70,P＜0.0001). (抗VEFG药物)不同注射剂量组间,最佳矫正视力和黄斑中心凹厚度差异无统计学意义(P＞0.05).抗VEFG药物注射较黄斑格栅样光凝)组,最佳矫正视力(明显改善)OR=3.97,95％ CI： (2.16-7.31),Z=4.43,P＜0.0001.安全性方面：严重并发症与注射过程有关而与药物本身无关.在发生眼痛、眼痛、眼压升高和高血压差异均无统计学意义(P＞0.05).结论 现有临床研究证据提示,(对于糖尿病性黄斑水肿的治疗)玻璃体(内)注射抗(VEGF药物)较假注射组和格栅样光凝组,均更能有效地提高视力,减轻黄斑水肿.可能需要联合治疗,如联合黄斑格栅样光凝)皮质类固醇激素等,减少抗VEGF药物的用药次数和剂量,这需更多前瞻性大样本临床随机对照试验支持.
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