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目的系统评价静脉冲击大剂量甲基强的松龙治疗甲状腺相关性眼病的疗效。方法计算机检索Cochrane Library、Pub Med、中国知网CNKI、中国生物医学文献数据库、万方数据库。检索时间为建库至2014年3月。全面检索大剂量甲基强的松龙静脉冲击治疗甲状腺相关眼病的随机对照试验(RCT),评价研究质量,提取相关数据,采用Rev Man5.0软件进行Meta分析。结果共纳入10项研究,共520例患者。根据干预措施进行亚组分析。甲基强的松龙静脉冲击治疗的有效率高于口服泼尼松组,差异有统计学意义[RR(95%CI)为1.48(1.26,1.73),P<0.000 01];甲基强的松龙联合球后放疗的有效率高于口服泼尼松联合球后放疗组,差异有统计学意义[RR(95%CI)为1.42(1.11,1.81),P=0.005]。甲基强的松龙静脉冲击治疗所致血压升高、体重增加的不良反应少于口服强的松组。结论大剂量甲基强的松龙静脉冲击疗法是甲状腺相关性眼病的有效治疗方案,全身副作用较少。
Objective To evaluate the efficacy of intravenous bolus methylprednisolone in the treatment of thyroid associated ophthalmopathy. Methods Cochrane Library, Pub Med, CNKI, China Biomedical Literature Database and Wanfang Database were searched by computer. Search time for the construction of the library until March 2014. A comprehensive randomized controlled trial (RCT) of high dose methylprednisolone pulse therapy for the treatment of thyroid associated ophthalmopathy was conducted. The quality of the study was evaluated and relevant data were extracted. Meta-analysis was performed using Rev Man5.0 software. Results A total of 10 studies were included, with a total of 520 patients. Subgroup analysis based on interventions. The effective rate of methylprednisolone pulse therapy was significantly higher than that of oral prednisone group [RR (95% CI: 1.48, 1.26, 1.73, P <0.0001] The effective rate of post-bolus radiotherapy was significantly higher than that of oral prednisolone combined with posterior retrobulbar radiotherapy [RR (95% CI 1.42, 1.11, 1.81, P = 0.005]. Methylprednisolone pulse therapy caused by elevated blood pressure, weight gain adverse reactions less than oral prednisone group. Conclusion High-dose methylprednisolone pulse therapy is an effective treatment for thyroid-related ophthalmopathy with less systemic side effects.