康柏西普玻璃体腔内注射治疗视网膜静脉阻塞并黄斑水肿的疗效观察及其影响因素分析

发布时间：2018-03-25 06:18

本文选题：视网膜静脉阻塞　切入点：黄斑水肿　出处：《新乡医学院》2017年硕士论文

【摘要】：背景随着人口老龄化的发展,与高血压病、高血脂症、糖尿病等疾病相关的视网膜病也逐渐增多,其中视网膜静脉阻塞是仅次于糖尿病视网膜病变的第2位常见视网膜血管疾病。一直以来都是眼科临床医师面临的难题。目前多种方法用于治疗视网膜静脉阻塞。其中玻璃体腔内注射抗VEGF药物是近年的热点,给眼底疾病的治疗模式带来了变革。康柏西普(conbercept)是我国自主研发的抗VEGF药物,但目前用于RVO继发黄斑水肿治疗的临床观察报道尚不多。目的评价康柏西普玻璃体腔内注射治疗视网膜静脉阻塞合并黄斑水肿的临床疗效,并对其影响因素进行分析。方法前瞻性临床自身对照研究。选择本院2014年11月至2016年7月收治的确诊为视网膜静脉阻塞(RVO)合并黄斑水肿(ME)的36例(36眼)患者,给予玻璃体腔内注射康柏西普治疗,观察其疗效、分析其影响因素。所有患者均用眼科常规检查方法及光学相干断层扫描(OCT),观察治疗前后最佳矫正视力(BCVA)、黄斑中心凹厚度(CMT)等变化,评价其治疗效果,并对年龄、病程及CMT等因素进行相关分析。结果1.半年后检查BCVA均不同程度提高,其中视力稳定16例,视力提高有效20例;治疗前平均BCVA(LogMAR值)为1.01±0.46,治疗后半年平均BCVA(LogMAR值)为0.66±0.45,(t=7.689,P0.05)差异有统计学意义;患者CMT均不同程度变薄,治疗前CMT 595.39±200.94μm,治疗后CMT 268.36±84.86μm,(t=11.602,P0.05)差异有统计学意义。2.相关因素分析结果:治疗效果与发病时间呈负相关(r=-0.573,P0.05)。CMT平均减轻厚度与治疗前CMT呈正相关(r=0.909,P0.05)。3.治疗过程中未见药物相关副作用和全身不良反应,未见眼内炎、视网膜撕裂、白内障等玻璃体腔注射相关的眼部并发症。结论1.玻璃体腔注射康柏西普治疗视网膜静脉阻塞合并黄斑水肿安全有效;2.发病时间越短,视力改善越明显;治疗前黄斑水肿越明显,其促进水肿吸收的效果越好,但长期治疗效果需进一步观察。
[Abstract]:Background with the development of aging population, retinopathy associated with hypertension, hyperlipidemia, diabetes and other diseases is also gradually increasing. Retinal vein occlusion is the second most common retinal vascular disease after diabetic retinopathy. It has always been a difficult problem for ophthalmologists. At present, many methods are used to treat retinal vein occlusion. Among them, intravitreal injection of anti- VEGF drugs is a hot spot in recent years. It has brought about a change in the treatment mode of fundus disease. Compactopril Conberceptis is an anti- VEGF drug developed independently in China. At present, there are few clinical reports on the treatment of macular edema secondary to RVO. Objective to evaluate the clinical effect of intravitreal injection of Compacipe in the treatment of retinal vein occlusion with macular edema. Methods 36 patients (36 eyes) who were diagnosed as retinal vein occlusion (RVO) with macular edema (MEM) from November 2014 to July 2016 were enrolled in this study. To observe the effect of intravitreous injection of Compactopril, The influencing factors were analyzed. All the patients were examined by routine ophthalmic examination and optical coherence tomography (Oct). The changes of BCVAV and CMT before and after treatment were observed, and the therapeutic effect was evaluated, and the age was evaluated. Results 1. After half a year, the BCVA was improved in different degree, the visual acuity was stable in 16 cases, and the visual acuity was improved in 20 cases. The average BCVA(LogMAR value before treatment was 1.01 卤0.46, and the average BCVA(LogMAR value half a year after treatment was 0.66 卤0.45U (P 0.05). There was significant difference in CMT 595.39 卤200.94 渭 m before treatment and 268.36 卤84.86 渭 m after treatment (P 0.05). The results of correlation factor analysis showed that there was a negative correlation between the effect of treatment and the onset time. There was a positive correlation between the average thickness of CMT before treatment and CMT before treatment. Effects and systemic adverse reactions, There were no intraocular complications associated with intravitreal injection, such as endophthalmitis, retinal tear and cataract. Conclusion 1. It is safe and effective to treat retinal vein occlusion with macular edema by intravitreal injection. The more obvious the improvement of visual acuity and the more obvious macular edema before treatment, the better the effect of promoting edema absorption, but the long-term therapeutic effect needs further observation.
【学位授予单位】：新乡医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R774.1

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