• 四川大學(xué)華西醫(yī)院藥劑科,四川成都 610041;

目的:評價皮質(zhì)激素聯(lián)合環(huán)孢素對比皮質(zhì)激素單用防治穿透性角膜移植(PKP)術(shù)后排斥反應(yīng)的療效。方法:計算機(jī)檢索PubMed,EMBASE.com,SCI,Cochrane圖書館,CBM,CNKI數(shù)據(jù)庫,納入皮質(zhì)激素聯(lián)用環(huán)孢素對比皮質(zhì)激素單用防治PKP術(shù)后排斥反應(yīng)的隨機(jī)對照試驗(yàn),進(jìn)行方法學(xué)質(zhì)量評價并應(yīng)用RevMan軟件進(jìn)行meta分析。結(jié)果:共納入5篇報道,1篇A級文獻(xiàn),B、C級各2篇。Meta結(jié)果:術(shù)后排斥反應(yīng)發(fā)生情況組間差異有統(tǒng)計學(xué)意義(RR=0.3,95%CI 0.140.65);對既發(fā)排斥反應(yīng)的逆轉(zhuǎn),組間差異無統(tǒng)計學(xué)意義(RR=1.15,95%CI 0.93-1.42)。結(jié)論:基于當(dāng)前證據(jù),皮質(zhì)激素聯(lián)合環(huán)孢素防治PKP術(shù)后排斥反應(yīng)療效并不優(yōu)于皮質(zhì)激素單用。

引用本文： 吳斌,蘇娜,程凱,胡海波,柳汝明,唐堯. 皮質(zhì)激素聯(lián)用環(huán)孢素防治穿透性角膜移植術(shù)后排斥反應(yīng)的meta分析. 華西醫(yī)學(xué), 2009, 24(6): 1365-1368. doi: 復(fù)制

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  1. 1. WILLIAMS K A, LOWE M T, BARLETT C M, et al. Report from the Australian Corneal Graft Registry[M]. Flinders University Press,2007.
  2. 2. MAUREEN G M, WALTER J S, JOHN D G, et al. Risk factors for corneal graft failure and rejection in the collaborative corneal transplantation studies [J]. Ophthalmology,1994,101:15361547.
  3. 3. JUNI P, ALTMAN D G, EGER M. Assessing the quality of controlled clinical trials [J]. BMJ,2001,323:42-46.
  4. 4. HIGGINS J P T, THOMPSON S G. Quantifying heterogeneity in a metaanalysis [J]. Stat Med,2002,21(11):1539-1558.
  5. 5. UNAL M, YUCEL I. Evaluation of topical ciclosporin 005% for prevention of rejection in highrisk corneal grafts [J]. Br J Ophthalmol,2008,92(10):1411-1414.
  6. 6. POON A, CONSTANTINOU M, LAMOUREUX E, et al. Topical Cyclosporin A in the treatment of acute graft rejection: a randomized controlled trial [J]. Clin Experiment Ophthalmol,2008,36(5):415-421..
  7. 7. NEJABAT M, KHOSHGHADAM J, EGHTEDARI M, et al. Topical cyclosporine A in corneal graft rejection [J]. Am J Immunol,2006,2(2):29-34.
  8. 8. 席興華,秦波,姜德詠,等.環(huán)孢霉素A和地塞米松防治穿透性角膜移植術(shù)后排斥反應(yīng)的臨床觀察[J].中南大學(xué)學(xué)報,2003,28(6):627-630.
  9. 9. 賀焱,孫秉基,李玉淳,等.環(huán)孢霉素A滴眼預(yù)防高危角膜移植免疫排斥的效果[J].眼外傷職業(yè)眼病雜志,1999,21(5):420-421.
  10. 10. HILL J C. Systemic cyclosporine in highrisk keratoplasty: longterm results[J]. Eye,1995,9(Pt4):422-428.