多佐胺和噻嗎洛爾聯用與拉坦前列腺素比較治療開角型青光眼的系統評價_《中國循證醫學雜志》

作者：

梅麗克木艾山 ,  具爾提哈德爾

新疆醫科大學第一附屬醫院眼科（烏魯木齊 830054）;

關鍵詞：

多佐胺和噻嗎洛爾聯用拉坦前列腺素開角型青光眼系統評價

DOI：

10.7507/1672-2531.20090066

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目的　系統評價多佐胺和噻嗎洛爾聯合用藥與拉坦前列腺素比較治療開角型青光眼的有效性和安全性。
方法　電子檢索MEDLINE（1966 ～ 2008）、 EMbase（1974 ～ 2008）、Cochrane Library（2007 年2 期）、CBM（1978 ～ 2008）、CNKI（1979 ～ 2008）和VIP（1989 ～ 2008），并手工檢索相關領域雜志，納入多佐胺和噻嗎洛爾聯用與拉坦前列腺素比較治療開角型青光眼的隨機對照試驗，并按Cochrane 系統評價方法選擇試驗、評價質量和提取有效數據，用RevMan 5.0 版軟件進行Meta 分析。
結果　共納入6 個隨機對照試驗，包括361 例患者，361 只眼。Meta 分析結果顯示：用藥后兩組眼壓降低率差異有統計學意義［WMD= – 0.49，95%CI（– 1.06，0.07），P=0.09］，眼部不良反應發生率差異無統計學意義［WMD=1.43，95%CI（0.49，4.21），P=0.51］；全身不良反應中頭痛的發生率差異也無統計學意義［WMD=0.40，95%CI（0.13，1.26），P=0.12］。
結論　與拉坦前列腺素比較，多佐胺和噻嗎洛爾聯用可提高眼壓降低率，但由于本系統評價納入研究質量及例數有限，上述結論尚需開展多中心、大樣本、隨機、雙盲對照試驗一步驗證。

引用本文： 梅麗克木艾山,具爾提哈德爾. 多佐胺和噻嗎洛爾聯用與拉坦前列腺素比較治療開角型青光眼的系統評價. 中國循證醫學雜志, 2009, 09(3): 350-354. doi: 10.7507/1672-2531.20090066 復制

1.	hypertension and glaucoma: a six-month masked, multicenter trial in the United States. Ophthalmology, 1996, 103(1): 138-147.
2.	He MG, Foster PJ, Ge J, et al. Prevalence and clinical characteristics of glaucoma in adult Chinese: a population 2 based study in liwan district, guang zhou. Invest Ophthalmol Vis Sci, 2006, 47(7): 2782-2788.
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4.	Alm A, Stjernschantz J. Effects on intraocular pressure and side effects of 0.005% latanoprost applied once daily, evening or morning. A comparison with timolol. Scandinavian Latanoprost Study Group. Ophthalmology, 1995, 102(12): 1743-1752.
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7.	Smith SL, Pruitt CA, Sine CS. The use of latanoprost 0.005% once daily to simplify medical therapy in patients with primary openangle glaucoma or ocular hypertension. Acta Ophthalmol Scand, 1999, 77(2): 189-192.
8.	Clineschmidt CM, Williams RD, Snyder E, et al. A randomized trial in patients inadequately controlled on timolol alone comparing the dorzolamide-timolol combination to monotherapy with timolol or dorzolamide. Ophthalmology, 1999, 106(12 Suppl): 17-24.
9.	Hutzelmann J, Owens S, Shedden A, et al. Comparison of the safety and efficacy of the fixed combination of dorzolamide/timolol and the concomitant administration of dorzolamide and timolol: a clinical equivalence study. Br J Ophthalmol, 1998, 82(11): 1249-1253.
10.	Boyle JE, Ghosh K, Gieser DK, et al. A randomized trial comparing the dorzolamide-timolol combination given twice daily to monotherapy with timolol or dorzolamide. Ophthalmology, 1999, 106(12 Suppl): 10-16.
11.	Polo V, Larrosa JM, Gomez ML, et al. Latanoprost versus combined therapy with timolol plus dorzolamide: IOP-lowering effect in openangle glaucoma. Acta Ophthalmol Scand, 2001, 79(1): 6-9.
12.	Honrubia FM, Larsson LI, Spiegel D. European latanoprost studygroup. A comparison of the effects on intraocular pressure of latanoprost 0.005% and the fixed combination of dorzolamide 2% and timolol 0.5% in patients with open-angle glaucoma. Acta Ophthalmol Scand, 2002, 80(6): 635-641.
13.	Martínez A, Sánchez M. A comparison of the effects of 0.005% latanoprost and fixed combination dorzolamide/timolol on retrobulbar haemodynamics in previously untreated glaucoma patients. Curr Med Res Opin, 2006, 22(1): 67-73.
14.	Mulaney J, Sonty S, Ahmad A, et al. Comparison of daytime efficacy and safety of dorzolamide/timolol maleate fixed combination versus latanoprost. Eur J Ophthalmol, 2008, 18(4): 556-562.
15.	Quaranta L, Miglior S, Floriani I, et al. Effects of the timololdorzolamide fixed combination and latanoprost on circadian diastolic ocular perfusion pressure in glaucoma. Invest Ophthalmol Vis Sci, 2008, 49(10): 4226-4231.
16.	Janulevicien? I, Harris A, Kagemann L, et al. A comparison of the effects of dorzolamide/timolol fixed combination versus latanoprost on intraocular pressure and pulsatile ocular blood flow in primary open-angle glaucoma patients. Acta Ophthalmol Scand, 2004, 82(6): 730-737.

1. hypertension and glaucoma: a six-month masked, multicenter trial in the United States. Ophthalmology, 1996, 103(1): 138-147.
2. He MG, Foster PJ, Ge J, et al. Prevalence and clinical characteristics of glaucoma in adult Chinese: a population 2 based study in liwan district, guang zhou. Invest Ophthalmol Vis Sci, 2006, 47(7): 2782-2788.
3. Zou YH, Chiou CY. New ideas for medical therapy of glaucoma in the future. International Journal of Ophthalmology, 2005, 5(3): 411.
4. Alm A, Stjernschantz J. Effects on intraocular pressure and side effects of 0.005% latanoprost applied once daily, evening or morning. A comparison with timolol. Scandinavian Latanoprost Study Group. Ophthalmology, 1995, 102(12): 1743-1752.
5. Camras CB and United States Latanoprost Study Group. Comparison of latanoprost and timolol in patients with ocular.
6. Watson P, Stjernschantz J and Latanoprost Study Group. A sixmonth, randomized, double-masked study comparing latanoprost with timolol in open-angle glaucoma and ocular hypertension. Ophthalmology, 1996, 103(1): 126-137.
7. Smith SL, Pruitt CA, Sine CS. The use of latanoprost 0.005% once daily to simplify medical therapy in patients with primary openangle glaucoma or ocular hypertension. Acta Ophthalmol Scand, 1999, 77(2): 189-192.
8. Clineschmidt CM, Williams RD, Snyder E, et al. A randomized trial in patients inadequately controlled on timolol alone comparing the dorzolamide-timolol combination to monotherapy with timolol or dorzolamide. Ophthalmology, 1999, 106(12 Suppl): 17-24.
9. Hutzelmann J, Owens S, Shedden A, et al. Comparison of the safety and efficacy of the fixed combination of dorzolamide/timolol and the concomitant administration of dorzolamide and timolol: a clinical equivalence study. Br J Ophthalmol, 1998, 82(11): 1249-1253.
10. Boyle JE, Ghosh K, Gieser DK, et al. A randomized trial comparing the dorzolamide-timolol combination given twice daily to monotherapy with timolol or dorzolamide. Ophthalmology, 1999, 106(12 Suppl): 10-16.
11. Polo V, Larrosa JM, Gomez ML, et al. Latanoprost versus combined therapy with timolol plus dorzolamide: IOP-lowering effect in openangle glaucoma. Acta Ophthalmol Scand, 2001, 79(1): 6-9.
12. Honrubia FM, Larsson LI, Spiegel D. European latanoprost studygroup. A comparison of the effects on intraocular pressure of latanoprost 0.005% and the fixed combination of dorzolamide 2% and timolol 0.5% in patients with open-angle glaucoma. Acta Ophthalmol Scand, 2002, 80(6): 635-641.
13. Martínez A, Sánchez M. A comparison of the effects of 0.005% latanoprost and fixed combination dorzolamide/timolol on retrobulbar haemodynamics in previously untreated glaucoma patients. Curr Med Res Opin, 2006, 22(1): 67-73.
14. Mulaney J, Sonty S, Ahmad A, et al. Comparison of daytime efficacy and safety of dorzolamide/timolol maleate fixed combination versus latanoprost. Eur J Ophthalmol, 2008, 18(4): 556-562.
15. Quaranta L, Miglior S, Floriani I, et al. Effects of the timololdorzolamide fixed combination and latanoprost on circadian diastolic ocular perfusion pressure in glaucoma. Invest Ophthalmol Vis Sci, 2008, 49(10): 4226-4231.
16. Janulevicien? I, Harris A, Kagemann L, et al. A comparison of the effects of dorzolamide/timolol fixed combination versus latanoprost on intraocular pressure and pulsatile ocular blood flow in primary open-angle glaucoma patients. Acta Ophthalmol Scand, 2004, 82(6): 730-737.

《中國循證醫學雜志》

多佐胺和噻嗎洛爾聯用與拉坦前列腺素比較治療開角型青光眼的系統評價

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《中國循證醫學雜志》

多佐胺和噻嗎洛爾聯用與拉坦前列腺素比較治療開角型青光眼的系統評價

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