CAJ | 학술논문

目的比较单纯黄斑区格栅样激光光凝(MLG)与玻璃体腔注射曲安奈德(IVTA)联合MLG治疗糖尿病黄斑水肿(DME)的有效性及安全性.方法计算机检索循证医学图书馆、荷兰医学文摘、生物医学数据库、中国生物医学文献数据库、中国期刊全文数据库及中文科技期刊全文数据库.收集IVTA联合MLG与MLG治疗DME临床随机对照试验(RCT),评价纳入研究的质量,提取有效数据,采用荟萃分析软件(RevMan)5.1进行meta分析.比较两种治疗方法对最佳矫正视力(BCVA)及黄斑中心凹厚度(CMT)的影响.结果共纳入6个RCT,共331只眼.其中,MLG组166只眼,IVTA联合MLG组165只眼.随访6个月时,IVTA联合MLG组与MLG组比较,BCVA差异无统计学意义(Z=1.27,P=0.20),但CMT差异有统计学意义(Z=2.41,P=0.02),眼压增高及白内障等并发症发生率差异有统计学意义(Z=3.62,P＜0.01).结论 IVTA联合MLG治疗DME可降低CMT,但在改善视功能方面与MLG比较无明显优势.这仍需要高质量的、大样本的RCT数据进一步论证.
목적 비교단순황반구격책양격광광응(MLG)여파리체강주사곡안내덕(IVTA)연합MLG치료당뇨병황반수종(DME)적유효성급안전성.방법 계산궤검색순증의학도서관、하란의학문적、생물의학수거고、중국생물의학문헌수거고、중국기간전문수거고급중문과기기간전문수거고.수집IVTA연합MLG여MLG치료DME림상수궤대조시험(RCT),평개납입연구적질량,제취유효수거,채용회췌분석연건(RevMan)5.1진행meta분석.비교량충치료방법대최가교정시력(BCVA)급황반중심요후도(CMT)적영향.결과 공납입6개RCT,공331지안.기중,MLG조166지안,IVTA연합MLG조165지안.수방6개월시,IVTA연합MLG조여MLG조비교,BCVA차이무통계학의의(Z=1.27,P=0.20),단CMT차이유통계학의의(Z=2.41,P=0.02),안압증고급백내장등병발증발생솔차이유통계학의의(Z=3.62,P＜0.01).결론 IVTA연합MLG치료DME가강저CMT,단재개선시공능방면여MLG비교무명현우세.저잉수요고질량적、대양본적RCT수거진일보론증.
Objective To evaluate the efficacy and safety of intravitreal triamcinolone acetonide combined of macular laser grid photocoagulation (IVTA/MLG) versus macular laser grid (MLG)photocoagulation only for treatment of diabetic macular edema.Methods A computerized search was conducted in the Cochrane Library, Embase Library, Pubmed,Chinese Biomedical Database,Chinese Journal Full-text Database and Chinese Science and Technology Periodicals Database.Randomized controlled trials (RCT) on IVTA/MLG and MLG only for treatment of diabetic macular edema were selected.After the data extraction,quality of RCT was assessed.The meta analysis was performed by RevMan 5.1.The outcome measures included best-corrected visual acuity (BCVA) and the central foveal thickness (CMT).Results In total,six RCT that fulfilled the eligibility criteria were included in the meta-analysis involving 166 eyes in MLG group and 165 eyes in IVTA/MLG group.The results suggested that there was no significant differences in BCVA (Z =1.27,P =0.20 ), but differences were statistically significant comparing CMT (Z=2.41,P=0.02),incidence of ocular hypertension and cataract (Z=3.62,P＜0.01)between MLG and IVTA/MLG groups at the six month follow-up.Conclusions There is no significant advantage of IVTA/MLG as compared with MLG,but it could reduce CMT.However,a high-quality,large sample RCT should be further investigated.