【摘要】：目的:玻璃體腔注射貝伐單抗與維替泊芬光動力療法治療AMD患者進行系統(tǒng)評價。方法:按照Cochrane系統(tǒng)評價方法,計算機檢索MEDLINE(1966-2009.12)、EMbase(1980-2009.12)、Cochrane圖書館(2009年3期)和中國生物醫(yī)學文獻數據庫(1979-2009.12),并手工檢索相關會議文獻。文獻語種限制為中、英文。收集所有相關隨機對照試驗,采用Cochrane協(xié)作網提供的RevMan5.0軟件進行Meta分析,以獲得玻璃體腔注射貝伐單抗與維替泊芬光動力療法治療AMD患者的相關證據。結果:經過全面檢索及篩查后,共納入2篇隨機對照試驗,共計229例患者,Meta分析結果顯示:在AMD患者中,采用貝伐單抗治療AMD CNV患者較PDT治療能提高最佳矯正視力(MD,0.09;95%CI,0.06to0.13;P0.00001),使視力明顯改善(最佳矯正視力能提高2行)[RR=2.98,95%CI(1.28,6.92)]并使最佳矯正視力能提高3行(RR=1.36;95%CI,1.09to 1.69;P=0.007),但單獨使用PDT治療較單獨使用伐單抗治療可以使中心凹厚度減少更明顯(MD,16.50;95%CI,3.56to29.44; P=0.01)。結論:在AMD患者中,采用貝伐單抗治療AMD CNV患者較PDT治療能提高最佳矯正視力,使視力明顯改善(最佳矯正視力能提高2行甚至3行),但PDT治療在減少中心凹厚度程度方面更明顯。但兩種治療方法與是否需要聯合治療,治療頻率以及最大線性測量等指標的關系,以及經濟學評價有待于進一步研究。因本系統(tǒng)評價納入研究病例數較少,上述結論尚需更多設計嚴謹的大樣本隨機對照試驗加以驗證。
[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.
【學位授予單位】：新疆醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2010
【分類號】：R774.5

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