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羟苯磺酸钙治疗非增殖性糖尿病性视网膜病变:系统回顾与Meta分析

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Keywords: 糖尿病视网膜病变,羟苯磺酸钙,随机对照临床试验,系统性回顾,荟萃分析

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Abstract:

多个随机临床对照试验结果已经证实羟苯磺酸钙治疗糖尿病视网膜病变(DR)的疗效及安全性.本研究旨在通过Meta分析评估羟苯磺酸钙治疗DR的有效性.对发表于1975年1月~2013年10月的共221篇英文文献进行分析及评估.以“糖尿病视网膜病变”和“羟苯磺酸钙”作为主题词分别于PubMed,SpringLink和Cochrane图书馆临床试验数据库的检索系统对随机对照试验进行检索.2位研究者独立进行研究选择、质量评估和信息提取.所提取的信息包括设计方案、入选和排除标准、样本大小、研究对象的平均年龄、治疗方案、最佳矫正视力、实验室指标、毛细血管脆性、眼压和眼底荧光血管造影表现.共有8个设计良好的Jadad评分为4级以上的临床试验及552名患者符合入组条件.Meta分析结果显示,羟苯磺酸钙可显著改善视网膜微血管瘤(RR:0.62,95%CI:0.42~0.90,P=0.01)、视网膜出血(RR:0.39,95%CI:0.17~0.88,P=0.02)、渗出(RR:0.31,95%CI:0.12~0.81,P=0.02),降低全血黏度(MD:-0.57CP,95%CI:-0.75~-0.38,P<0.001)、血浆黏度(MD:-0.36CP,95%CI:-0.63~-0.09,P=0.01)、血胆固醇(MD:-0.48mg/mL,95%CI:-0.64~0.33,P<0.00001).也可显著降低DR合并青光眼患者的眼压(MD:-5.59mmHg,95%CI:-6.69~-4.50,P<0.00001).结果表明,羟苯磺酸钙在系统全身及眼局部治疗DR均具有有效性.

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