l120ChinOphthalRes，December2009，Vo1．27，No．12·临床研究·卢美根与噻吗心安治疗高眼压疗效对比的Meta分析葛轶睿王理理程金伟黄振平Ameta-analysisoftherapycomparisonbetweenbimatoprostandtimololinocularhypertentioneyeGeYirui，WangLili，ChengJinwei，HuangZhenping．DepartmentofOphthalmology，ⅣnnjingGeneralHospitalofNanjingMilitaryCommand．N8njing210002．ChinaAbstractObjectiveManyresearcheshavedemonstratedthelowing—intraocularpressure(IOP)efectsofbimatoprostandtimolo1．However，nopowerfulevidenceshowedwhichdrughasthebetterefficacy．Thisstudywastoperformameta—analysistoevaluatetheefficacyandtolerabilityofbimatoprostcomparedwithlatanoprostinlowingIOP．MethodsThiswasaevidence—basedmedicinesciencestudy．PertinentstudieswereidentifiedthroughsearchesofPubMed，EMBASE，theCochraneLiberaryControlledTrialsRegisterandChineseBiomedicineDatabaseusingthetermsoftimolol，blocardren，temserin，timoptic，bimatoprost，lumigan．TheintensivesearchingbyhandanduptoOctober1，2008wasalsodesigned．ResultsSixrandomizedandcontrolledstudiesenrollingatotalof2094patientswereincludedinthemeta-analysisandthreeclinicalindexeswereanalyzed．BimatoprostwasassociatedwithgreaterdeclinevaluefrombaselineIOPincomparisonwithtimololfP<0．01)withaweightmeandiference一2．04atfinalpoint(95％CI：一2．44to一1．64)．NumericallygreaterproportionsofbimatoprostpatientsthantimololpatientsachievedthetargetIOPat3months(from3literature)and>6months(from21iterature)withapooledRRof1．87(95％CI：1．45to2．41)，1．60(95％CI：1．36to1．90)(P<0．01)，respectively．BimatoprostshowedamorefrequenciesintheadverseeffectssuchasconjunctivalhyperemiaandeyelashgrowththantimololwithanRRof4．18(95％CI：2．89to6．05)，9．40(95％CI：5．62to15．71)．Noobviousdrug-relatedsideeffectwasfoundfromliteratureanalysisincludedbothdrugs．ConclusionSearchedliteratureoffersgradeAofevidencesforthecomparisonclinicalevaluationoftherapyeficacybetweenbimatoprostandtimololinlowingIOP．BimatoprosthasabettereficacyinloweringIOPandreachingcomparableproportionsofpatientswithtargetIOPthantimolo1．Bothagentsarewelltolerated．Keywordsbimatoprost；timolol；highintraocularpressure；meta—analysis；evidence—basedmedicine摘要目的研究卢美根与噻吗心安在青光眼与高眼压症患者中降压的有效性，并观察不良反应。方法检索PubMed、EMBASE、TheCochraneLibraryControlledTrialsRegister及中国生物医学文献数据库收录的有关卢美根与噻吗心安治疗青光眼与高眼压症的对照研究，并辅以手工检索、因特网搜索。对纳入的6项随机对照试验，针对眼压下降比例、达到目标眼压人数、药物不良反应3项内容进行综合分析。结果卢美根降眼压效果优于噻吗心安，差异有统计学意义(P<0．01)[合并的加权均数差(WMD)=一2．04％，95％CI(一2．44，一1．64)]。3篇文献报道随访3个月时达到目标眼压的患者人数，卢美根组与噻吗心安组比较差异有统计学意义(P<0．01)[合并危险比(RR)=1．87，95％CI(1．45，2．41)]；2篇文献报道随访>6个月时达到目标眼压患者人数，卢美根组与噻吗心安组比较差异有统计学意义(P<0．01)[合并RR=1．60，95％CI(1．36，1．90)]。结膜充血及睫毛变长为拟前列腺素类抗青光眼药物2种较为常见的不良反应，其发生率卢美根组与噻吗心安组比较，差异均有统计学意义(P<0．O1)[合并RR=4．18，95％CI(2．89，6．05)、RR=9．40，95％CI(5．62，15．71)]。结论卢美根在降低眼压的程度和随访不同时期达到目标眼压的人数方面均优于噻吗心安。除结膜充血及睫毛变长的发生率卢美根组高于噻吗心安组外，2种药物均未发现有严重的药物相关不良反应。关键词卢美根；噻吗心安；高眼压；Meta分析；循证医学分类号R775R...
