玻璃体腔注射康柏西普治疗DR的疗效和安全性的Meta分析

目的：系统评价康柏西普治疗糖尿病视网膜病变(DR)的疗效和安全性，为临床用药提供参考。

方法：计算机检索Cochrane 图书馆、PubMed数据库、中国知网(CNKI)和万方医学网，收集康柏西普与常规治疗对DR的随机对照试验，提取相关资料并按照修改后的Jadad评分量表评价纳入研究文献质量，采用RevMan 5.3统计软件进行Meta分析。

结果：共纳入22项随机对照研究，合计1 878例患者。Meta分析结果显示，与对照组相比，康柏西普显著降低随访1、3mo患者视力、黄斑中心凹视网膜厚度(CMT)、手术时间、血管内皮生长因子(VEGF)水平及N1波潜伏期； 显著提高治疗有效率、自理能力、活动能力、社交能力和心理能力4个维度的生活质量评分，与对照组具有显著的统计学差异。安全性方面，康柏西普显著降低前房炎症、角膜水肿、高眼压、术中出血、医源性视裂孔、玻璃体出血、视网膜脱离及总并发症发生率，与对照组具有显著的统计学差异。根据对照组处理方式进行亚组分析，结果与全组分析一致。

结论：对于DR患者，玻璃体腔内单纯注射康柏西普或联合玻璃体切除术，均能取得较好的疗效和安全性，改善病情，提高患者生活质量。

Systematic evaluation of the effectiveness and safety of intravitreal injection of Conbercept for diabetic retinopathy

AIM: To evaluate the effectiveness and safety of Conbercept for diabetic retinopathy(DR)systematically, in order to provide evidence-based reference for clinical use.

METHODS:We performed a comprehensive search for the randomized controlled trials(RCTs)about Conbercept trail group vs control group in the treatment of DR published from PubMed, Cochrane Library, CNKI and Wanfang Database. Studies obtained from eligible database were filtered according to modified Jadad scale, and data were retrieved from those studies for further analysis. Then, we performed a Meta analysis using RevMan 5.3 statistical software.

RESULTS:A total of 22 RCTs were included, involving 1 878 patients. The results of Meta-analysis showed that visual acuity at 1 and 3mo, the central macular retinal thickness(CMT), operation time, the level of vascular endothelial growth factor(VEGF)and the implicit time of N1 wave were markedly decreased after treatment; the scores of self-care ability, social ability, activity ability, and psychological ability and response rates after treatment were significantly improved; and which were statistically different to control group. As for safety, the incidences of anterior chamber inflammation reaction, corneal edema, ocular hypertension, bleeding in operation, vitreous hemorrhage, iatrogenic visual hiatus and retinal detachment, complication incidence were more significantly decreased than control group. The same results were gained in subgroup.

CONCLUSION:The existing evidence supports that conbercept has good therapeutic efficacy and safety for DR.