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JAMA:葡萄膜炎全身皮质类固醇和免疫抑制治疗与玻璃体腔植入临床长期结果

2017-05-08 zhangfan MedSci原创

对于各型葡萄膜炎患者,全身皮质类固醇和免疫抑制治疗比玻璃体腔植入表现出更好的抑制视力衰退的结果并且全身副作用相近

2年以及4.5年的临床研究表明植入氟新诺龙丙酮(肤轻松)与全身性糖皮质激素治疗相比对于严重的非感染性的葡萄膜炎患者无显著的疗效优势,但长期结果尚不清楚。近日研究人员公布了长达7年的临床研究结果

研究包含255名13岁以上的各期葡萄膜炎患者,其中215人完成了7年的长期随访。参与者被随机分配接受玻璃体腔手术放置肤轻松植入体或全身糖皮质激素辅以免疫抑制治疗。主要终点是最佳矫正视力变化,次要终点包括皮质类固醇和免疫抑制治疗潜在全身毒性和死亡。

7年的研究资料来自161例(70%)植入病例以及167例(71%)全身治疗病例,其中77%为女性,招募时平均年龄48岁。招募时植入组平均视力61.7,全身治疗组65.0,研究7年后,植入组平均视力55.8,全身治疗组66.2,全身治疗组视力检查领先7.2个字符(95% CI, 2.1-12)。不良事件研究表明,植入组vs全身治疗组,高脂血症(6.1% vs 11.2%),高血压(9.8% vs 18.4%),骨量减少(41.5% vs 43.1%),骨折(11.3% vs 18.6%),住院率(47.6% vs 42.3%),抗生素治疗感染(57.4% vs 72.3%)。

7年随访试验表明,对于各型葡萄膜炎患者,全身皮质类固醇和免疫抑制治疗比玻璃体腔植入表现出更好的抑制视力衰退的结果并且全身副作用相近。

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    2017-05-10 jiyangfei
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    2017-05-08 九九消寒

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