文章摘要
苏建华,陈燕萍,包纪盛,黄 伟.糖皮质激素静脉冲击疗法与常规口服治疗在Graves眼病中应用的Meta分析[J].南京医科大学学报,2014,(7):996~1000
糖皮质激素静脉冲击疗法与常规口服治疗在Graves眼病中应用的Meta分析
Evaluation of intravenous glucocorticoid pulse therapy and oral route in the management of Graves’ ophthalmopathy:a meta analysis
投稿时间:2013-10-08  
DOI:10.7655/NYDXBNS20140729
中文关键词: 糖皮质激素  静脉冲击疗法  常规口服治疗  Graves眼病  Meta分析
英文关键词: glucocorticoid  pulse therapy  oral route  Graves’ ophthalmopathy  Meta analysis
基金项目:
作者单位
苏建华 南京医科大学附属无锡第二人民医院老年医学科,江苏 无锡 214002 
陈燕萍 南京医科大学附属无锡第二人民医院老年医学科,江苏 无锡 214003 
包纪盛 南京医科大学附属无锡第二人民医院老年医学科,江苏 无锡 214004 
黄 伟 南京医科大学附属无锡第二人民医院老年医学科,江苏 无锡 214005 
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中文摘要:
      目的:评价糖皮质激素静脉冲击疗法与常规口服治疗应用于Graves眼病的临床有效性及安全性?方法:以计算机及手工检索国内外比较糖皮质激素静脉冲击疗法及常规口服治疗在Graves眼病患者中应用的随机对照研究(RCT),按照Cochrane系统评价方法,筛选文献?评价纳入文献质量,使用Revman5.2软件进行系统统计分析?结果:共检索到相关文献54篇,评价后纳入5项研究,共265例患者,其中糖皮质激素静脉冲击疗法组134例,常规口服治疗组131例?Meta分析研究结果显示:①临床效果:糖皮质激素静脉冲击治疗组较常规口服治疗组可有效改善患者临床活动度评分(WMD=0.82,95%CI:0.61~1.03,P < 0.001)?突眼度(WMD = 0.62,95%CI:0.11~1.12,P = 0.02)?眼裂宽度(WMD = 0.72,95%CI:0.14~1.30,P = 0.01),但两组在改善复视方面无明显统计学差异(OR = 1.51,95%CI:0.77~2.95,P = 0.23)?②安全性:静脉冲击疗法组较口服治疗组有较低的不良事件发生率(OR = 0.16,95%CI:0.08~0.30,P < 0.001)?结论:与常规口服治疗组比较,静脉冲击疗法对Graves眼病具有更好的治疗效果,且安全性高?
英文摘要:
      Objective:To compare clinical efficacy and safety between intravenous glucocorticoid (IVGC) pulse therapy and oral route in the management of Graves’ ophthalmopathy. Methods:All randomized controlled trials (RCTs) comparing IVGC with oral route for the management of Graves’ ophthalmopathy were identified by manual and computer retrieval. All related data were extracted. Meta analysis was conducted using the statistical software RevMan 5.2 on the basis of strict quality evaluation with the methods recommended by the Cochrane Collaboration. Results:Fifty-four papers were found and 5 RCTs involving 256 patients (134 patients in the IVGC group and 131 patients in the oral route group) were included. The meta analysis showed that the IVGC group was associated with significant improvement of clinical activity score (CAS) compared with the oral route group (WMD = 0.82,95%CI:0.61~1.03,P < 0.001),proptosis (WMD = 0.62,95%CI:0.11~1.12,P = 0.02),lid width (WMD = 0.72,95%CI:0.14~1.30,P = 0.01),but the reduction of diplopia showed no difference between the two groups (OR = 1.51,95%CI:0.77~2.95,P = 0.23). IVGC had lower incidence of side effects than the oral route (OR=0.16,95%CI:0.08~0.30,P < 0.001). Conclusion:Compared with the oral route,IVGC pulse therapy showed better efficacy and safety in the management of Graves’ ophthalmopathy.
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