国际眼科杂志
國際眼科雜誌
국제안과잡지
INTERNATIONAL JOURNAL OF OPHTHALMOLOGY
2014年
3期
430-434
,共5页
吴杨杨%宋胜仿%李华%吕莎
吳楊楊%宋勝倣%李華%呂莎
오양양%송성방%리화%려사
拉坦前列素%噻吗心安%原发性开角型青光眼%高眼压症%有效性%安全性%Meta分析%系统评价
拉坦前列素%噻嗎心安%原髮性開角型青光眼%高眼壓癥%有效性%安全性%Meta分析%繫統評價
랍탄전렬소%새마심안%원발성개각형청광안%고안압증%유효성%안전성%Meta분석%계통평개
latanoprost%timolol%primary open angle glaucoma%ocular hypertension%efficacy%safety%Meta-analysis%systematic review
目的：系统评价拉坦前列素（ Latanoprost ）滴眼液与噻吗心安（Timolol）滴眼液降眼压的有效性和安全性。<br> 方法：计算机检索PubMed，Medline，CNKI及中国生物医学文献数据库收录的，并辅以手工检索、因特网搜索的有关拉坦前列素与噻吗心安治疗原发性开角型青光眼和高眼压症的随机对照试验（ RCT ）。按照纳入和排除标准限定研究对象，通过Jadad 评分量表进行文献质量评估后，针对眼压下降比例、药物不良反应2项内容，使用Cochrane协作网提供的RevMan 5．0软件进行Meta分析。<br> 结果：共纳入9项RCT，合计555例患者。 Meta分析结果显示：（1）拉坦前列素滴眼液与噻吗心安滴眼液降眼压效果，在2，6，12wk时差异均有统计学意义（ P＜0．01），加权平均差（WMD）分别为：在2wk[WMD＝-0．76，95％CI（-1．32，-0．20）]，在6wk[WMD＝-1．15，95％CI（-1．68，0．63）]和12wk[WMD＝-1．01，95％CI（-1．42，-0．61）]。（2）随访结束时，结膜充血、异物感为拉坦前列素的两种较为常见的不良反应，但其发生率拉坦前列素组与噻吗心安组比较，结膜充血的发生率[OR＝2．25，95％CI（0．99，5．08）]，异物感的发生率[OR＝2．48，95％CI（1．02，6．03）]，显示二者差异均无统计学意义。<br> 结论：治疗原发性开角型青光眼和高眼压症，拉坦前列素降眼压效果在用药12 wk内较噻吗心安好；两者在12 wk内引起结膜充血、异物感、虹膜色素加深、视野损害等的不良反应方面，差异不明显。由于纳入研究的样本量偏小，且方法学质量中等，致使本系统评价结果论证强度不高，因此还需要开展更多的高质量的临床随机对照研究，以便更客观、准确、全面地评价其疗效和安全性。
目的：繫統評價拉坦前列素（ Latanoprost ）滴眼液與噻嗎心安（Timolol）滴眼液降眼壓的有效性和安全性。<br> 方法：計算機檢索PubMed，Medline，CNKI及中國生物醫學文獻數據庫收錄的，併輔以手工檢索、因特網搜索的有關拉坦前列素與噻嗎心安治療原髮性開角型青光眼和高眼壓癥的隨機對照試驗（ RCT ）。按照納入和排除標準限定研究對象，通過Jadad 評分量錶進行文獻質量評估後，針對眼壓下降比例、藥物不良反應2項內容，使用Cochrane協作網提供的RevMan 5．0軟件進行Meta分析。<br> 結果：共納入9項RCT，閤計555例患者。 Meta分析結果顯示：（1）拉坦前列素滴眼液與噻嗎心安滴眼液降眼壓效果，在2，6，12wk時差異均有統計學意義（ P＜0．01），加權平均差（WMD）分彆為：在2wk[WMD＝-0．76，95％CI（-1．32，-0．20）]，在6wk[WMD＝-1．15，95％CI（-1．68，0．63）]和12wk[WMD＝-1．01，95％CI（-1．42，-0．61）]。（2）隨訪結束時，結膜充血、異物感為拉坦前列素的兩種較為常見的不良反應，但其髮生率拉坦前列素組與噻嗎心安組比較，結膜充血的髮生率[OR＝2．25，95％CI（0．99，5．08）]，異物感的髮生率[OR＝2．48，95％CI（1．02，6．03）]，顯示二者差異均無統計學意義。<br> 結論：治療原髮性開角型青光眼和高眼壓癥，拉坦前列素降眼壓效果在用藥12 wk內較噻嗎心安好；兩者在12 wk內引起結膜充血、異物感、虹膜色素加深、視野損害等的不良反應方麵，差異不明顯。由于納入研究的樣本量偏小，且方法學質量中等，緻使本繫統評價結果論證彊度不高，因此還需要開展更多的高質量的臨床隨機對照研究，以便更客觀、準確、全麵地評價其療效和安全性。
목적：계통평개랍탄전렬소（ Latanoprost ）적안액여새마심안（Timolol）적안액강안압적유효성화안전성。<br> 방법：계산궤검색PubMed，Medline，CNKI급중국생물의학문헌수거고수록적，병보이수공검색、인특망수색적유관랍탄전렬소여새마심안치료원발성개각형청광안화고안압증적수궤대조시험（ RCT ）。안조납입화배제표준한정연구대상，통과Jadad 평분량표진행문헌질량평고후，침대안압하강비례、약물불량반응2항내용，사용Cochrane협작망제공적RevMan 5．0연건진행Meta분석。<br> 결과：공납입9항RCT，합계555례환자。 Meta분석결과현시：（1）랍탄전렬소적안액여새마심안적안액강안압효과，재2，6，12wk시차이균유통계학의의（ P＜0．01），가권평균차（WMD）분별위：재2wk[WMD＝-0．76，95％CI（-1．32，-0．20）]，재6wk[WMD＝-1．15，95％CI（-1．68，0．63）]화12wk[WMD＝-1．01，95％CI（-1．42，-0．61）]。（2）수방결속시，결막충혈、이물감위랍탄전렬소적량충교위상견적불량반응，단기발생솔랍탄전렬소조여새마심안조비교，결막충혈적발생솔[OR＝2．25，95％CI（0．99，5．08）]，이물감적발생솔[OR＝2．48，95％CI（1．02，6．03）]，현시이자차이균무통계학의의。<br> 결론：치료원발성개각형청광안화고안압증，랍탄전렬소강안압효과재용약12 wk내교새마심안호；량자재12 wk내인기결막충혈、이물감、홍막색소가심、시야손해등적불량반응방면，차이불명현。유우납입연구적양본량편소，차방법학질량중등，치사본계통평개결과론증강도불고，인차환수요개전경다적고질량적림상수궤대조연구，이편경객관、준학、전면지평개기료효화안전성。
AIM:To evaluate the efficacy and safety of latanoprost versus timolol for primary open angle glaucoma ( POAG) and ocular hypertension ( OHT) . <br> METHODS: This was an evidence -based medicine science study.Pertinent studies of randomized controlled trial ( RCT) were identified through searches of PubMed, Medline, CNKI and China Biology Medicine disc. The intensive searching by hand and internet was also designed.According to inclusion and exclusion criteria, the study object was limited.Quality of literatures were evaluated by experienced researchers according to the Jadad Score.RevMan 5.0 offered by Cochrane was used for Meta-analysis aimed at the ratio of low intraocular tension and adverse drug reaction. <br> RESULTS: A total of 9 RCT sadded up to 555 patients were involved.The results of meta-analysis showed that, a) the difference at 2, 6, 12wk both had statistical significance, latanoprost showed greater intraocular pressure ( IOP) lowering efficacy compared with timolol. The weighted mean difference (WMD) at 2, 6, 12wk was respectively [-0.76, 95% CI (-1.32 to -0.20)], [-1.15, 95%CI (-1.68 to 0.63)] and [-1.01, 95%CI (-1.42 to-0.61)]. b) The difference in conjunctival congestion ( OR=2.25, 95% CI 0.99 to 5.08) and foreign body sensation ( OR=2.48, 95% CI 1.02 to 6.03 ) between latanoprost and timolol group was not statistically significant. <br> CONCLUSION: Latanoprost showed greater IOP lowering efficacy at 12wk compared with timolol for OAG and OH patients. The conjunctival hyperemia, foreign body sensation, iris pigmentation deepened, vision damage of latanoprost group at 12wk compared with timolol, the difference was not significant. This conclusion is not powerful enough in proof due to the medium methodology quality of the included studies, so a large number of high-quality RCTs with large sample are needed for objectively, precisely and entirely evaluating the efficacy.
