本文選題：皮質(zhì)類固醇類藥物　切入點(diǎn)：缺血性視神經(jīng)病變　出處：《吉林大學(xué)》2011年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：評價(jià)全身應(yīng)用皮質(zhì)類固醇類藥物對缺血性視神經(jīng)病變(ischemic optic neuropathy, ION)的治療作用。 方法：不受發(fā)表狀態(tài)和盲法的限制,以適當(dāng)?shù)臋z索式在Cochrane對照試驗(yàn)注冊資料庫、Ovid-medline全文數(shù)據(jù)庫(1950-2011.1)、中國生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫(CBMdisc,1950-2011.1)、Embase數(shù)據(jù)庫(1950-2011.1)、CNKI數(shù)據(jù)庫(1950-2011.1)進(jìn)行機(jī)檢,對相關(guān)學(xué)術(shù)會議論文匯編和紙質(zhì)眼科雜志等進(jìn)行手檢,并查閱相關(guān)的綜述性文章,對其參考引用的相關(guān)文獻(xiàn)資料進(jìn)行進(jìn)一步檢閱,全面收集全身應(yīng)用皮質(zhì)類固醇類藥物治療缺血性視神經(jīng)病變的臨床隨機(jī)對照試驗(yàn)(randomized controlled trial, RCT)、半隨機(jī)對照試驗(yàn)、臨床對照試驗(yàn)(controlled clinical trial, CCT)或者隊(duì)列研究(Cohort study)的文獻(xiàn),根據(jù)Jadad評分量表的標(biāo)準(zhǔn)進(jìn)行質(zhì)量評價(jià),并進(jìn)行數(shù)據(jù)資料的提取,應(yīng)用Reviewmanager 5.0軟件包對視力、視野與缺血性視神經(jīng)病變合并統(tǒng)計(jì)量進(jìn)行定量綜合分析、異質(zhì)性檢驗(yàn)、合并統(tǒng)計(jì)量檢驗(yàn),并評價(jià)發(fā)表偏倚,對分析結(jié)果做敏感性分析。 結(jié)果：在檢索到的929篇可能相關(guān)的中文及外文文獻(xiàn)中,有6篇文章符合嚴(yán)格的納入標(biāo)準(zhǔn),最終被納入研究。治療效果合并分析結(jié)果顯示,各指標(biāo)所納入文獻(xiàn)資料之間均具有同質(zhì)性(P0.05,I250%),使用固定效應(yīng)模型；敏感性分析結(jié)果顯示,各項(xiàng)指標(biāo)敏感性分析結(jié)果均無差別,提示結(jié)果穩(wěn)定；發(fā)表偏倚分析結(jié)果顯示,各項(xiàng)指標(biāo)漏斗圖都略顯不對稱,尤其是全身應(yīng)用皮質(zhì)類固醇類藥物治療ION患者視野組僅有兩項(xiàng)文獻(xiàn)納入,提示各項(xiàng)指標(biāo)可能存在發(fā)表偏倚；合并結(jié)果顯示,與對照組相比,全身應(yīng)用皮質(zhì)類固醇類藥物組患者：①ION視力改善合并OR：1.75,95%CI[1.22,2.51],有統(tǒng)計(jì)學(xué)意義。②Non-arteritic ION視力改善合并OR：2.22,95%CI[1.46,3.38],有統(tǒng)計(jì)學(xué)意義。③ION視野改善OR：1.93,95%CI[1.23,3.02],有統(tǒng)計(jì)學(xué)意義。與對照組相比,口服潑尼松組患者：ION視力改善合并OR：2.24,95%CI[1.47,3.42],有統(tǒng)計(jì)學(xué)意義。 結(jié)論：全身應(yīng)用皮質(zhì)類固醇類藥物對非動(dòng)脈炎性缺血性視神經(jīng)病變、缺血性視神經(jīng)病變視力的改善均有良好的控制作用�？诜䴘娔崴蓪θ毖砸暽窠�(jīng)病變視力的改善有良好的控制作用。全身應(yīng)用皮質(zhì)類固醇類藥物對缺血性視神經(jīng)病變患者視野的改善有良好的控制作用。但是我們?nèi)孕枰_展一系列更高質(zhì)量的研究來證實(shí)。
[Abstract]:Aim: to evaluate the therapeutic effect of corticosteroids on ischemic optic neuropathyin ischemic optic neuropathy (ION). Methods: without the limitation of publication status and blind method, the full text database of Ovid-medline and the Chinese biomedical literature database were checked by appropriate retrieval method in Cochrane controlled trial database (1950-2011) and Embase database (1950-2011 / 1). To carry on the hand examination to the related academic conference paper compilation and the paper ophthalmology magazine, and to consult the related summary article, carries on the further review to its reference citation related literature material, The literature of randomized controlled controlled trial, controlled clinical trial, semi-randomized controlled trial, cohort study or cohort study on ischemic optic neuropathy treated with corticosteroid drugs were collected. According to the standard of Jadad score scale, the quality evaluation was carried out, and the data was extracted. The combined statistics of visual acuity, visual field and ischemic optic neuropathy were analyzed by Reviewmanager 5.0 software package, and the heterogeneity test was used to test the heterogeneity of visual acuity, visual field and ischemic optic neuropathy. Statistical test was combined and publication bias was evaluated. Sensitivity analysis of the results was made. Results: of the 929 Chinese and foreign literatures that might be relevant, 6 articles met the strict inclusion criteria and were eventually included in the study. The results of sensitivity analysis showed that the results of sensitivity analysis showed that the results of sensitivity analysis showed that the results of sensitivity analysis were stable, and the results of published bias analysis showed that, The funnel graph showed a slight asymmetry, especially in the visual field group of patients with ION treated with corticosteroid drugs. Only two articles were included in the study group, indicating that the indicators might have a bias of publication, and the combined results showed that, compared with the control group, there was a significant difference between the two groups. In the whole body corticosteroid drug group, the visual acuity of the patients with 1: 1 ion + OR1.75 + 95CI [1.222.51], the visual acuity improvement of non-arteritic ION with OR: 2.222.995 CI [1.463.38], the visual field improvement of OR-1.9395CI [1.233.02] were statistically significant compared with those of the control group. In oral prednisone group, the visual acuity was improved with OR: 2.24 + 95 + CI [1.47 鹵3.42], which was statistically significant. Conclusion: corticosteroids are used in the treatment of non-arterial inflammatory ischemic optic neuropathy. The improvement of visual acuity of ischemic optic neuropathy was well controlled. Oral prednisone had a good control effect on the improvement of visual acuity of ischemic optic neuropathy. Systemic application of corticosteroids on ischemic optic nerve. The improvement of visual field in patients with disease is well controlled, but we still need to do a series of higher quality studies to confirm it.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2011
【分類號】：R774.6

【引證文獻(xiàn)】

相關(guān)碩士學(xué)位論文 前1條

1 翟瑜加;特發(fā)性黃斑裂孔術(shù)中內(nèi)界膜撕除與否的Meta分析[D];吉林大學(xué);2012年

，

本文編號：1584854