康柏西普对黄斑水肿的疗效和安全性的Meta-分析

目的 系统评价康柏西普治疗黄斑水肿的疗效和安全性，为临床用药提供参考。方法 计算机检索Cochrane图书馆（The Cochrane Library）、PubMed、中国期刊全文数据库（CNKI）和万方医学网，收集康柏西普与对照组比较对黄斑水肿治疗的随机对照试验（RCT），提取相关资料并按照Jadad评分量表评价纳入研究质量，采用RevMan 5.3统计软件进行Meta-分析。结果 共纳入21项RCTs，合计1 337例患者。Meta-分析结果显示，与对照组比较，康柏西普显著提高患者随访1个月［MD=0.08，95% CI（0.05，0.12），P<0.001］，3个月［MD=0.09，95% CI（0.06，0.13），P<0.001］和6个月［MD=0.07，95% CI（-0.02，0.17），P=0.12］最佳矫正视力（BCVA）及治疗有效率［RR=2.15，95% CI（1.29，3.57），P=0.003］；显著降低患者随访1个月［MD=-79.71，95% CI（-107.52，-51.91），P<0.001］、3个月［MD=-61.12，95% CI（-82.42，-39.81），P<0.001］和6个月［MD=-67.95，95% CI（-201.37，65.46），P=0.32］黄斑中心凹视网膜厚度（CMT）；除随访6个月的CMT和BCVA与对照组比较没有统计学差异（P=0.12、0.32），其余指标与对照组差异具有显著的统计学意义。剔除治疗方案差异（单次玻璃体腔注药）的一项研究再做Meta-分析后，两组6个月CMT和BCVA与对照组比较具有统计学差异（P=0.01、0.001）。不良反应方面，两组不具有统计学差异。结论 对于黄斑水肿患者，康柏西普短期内（3个月）比对照组更好的降低黄斑中心凹厚度、改善患者视力、提高治疗有效率，疗效可靠且耐受性好。

Meta-analysis of effectiveness and safety of Conbercept treating macular edema

Objective To evaluate the effectiveness and safety of Conbercept for macular edema (ME) systematically, in order to provide evidence-based reference for clinical use. Methods The pertinent randomized controlled trials (RCTs) about Conbercept trail group and control group in the treatment of ME were retrieved from Cochrane Library, PubMed, CNKI and Wan fang Database. The quality of included studies were evaluated after extracting data and according to modified Jadad scale. Meta-analysis was performed by using RevMan 5.3 statistical software. Results A total of 21 RCTs were included,involving 1337 patients. The results of Meta-analysis showed that best corrected visual acuity (BCVA) at 1 monthMD=0.08, 95%CI (0.05, 0.12), P<0.001], 3 monthMD=0.09, 95%CI (0.06, 0.13), P<0.001] and 6 monthMD=0.07, 95%CI (-0.02, 0.17), P=0.12] and therapeutic efficiency ratioRR=2.15, 95%CI (1.29, 3.57), P=0.003] were significantly improved; the central macular thickness (CMT) was markedly decreased at 1 monthMD=-79.71, 95%CI(-107.52, -51.91), P<0.001], 3 monthsMD=-61.12, 95%CI (-82.42, -39.81), P<0.001] and 6 monthsMD=-67.95, 95% CI(-201.37, 65.46), P=0.32] after treatment; and which was statistically different to control group, but BCVA and CMT at 6 months (P=0.12 and P=0.32). when a different study in treatment regimens was eliminated, then, the BCVA and CMT at 6 months was statistically different to control group (P=0.01 and P=0.001). Conclusion Conbercept has good therapeutic efficacy and safety for ME and effectively decrease CMT, improve BCVA and therapeutic efficiency ratio at the end of 3 months.