玻璃体腔注射雷珠单抗联合黄斑区格栅样光凝治疗视网膜分支静脉阻塞继发黄斑水肿的效果

发布时间：2018-04-23 21:45

本文选题：视网膜分支静脉阻塞 + 黄斑水肿　；参考：《中国当代医药》2016年17期

【摘要】：目的观察玻璃体腔注射雷珠单抗联合黄斑区格栅样光凝治疗视网膜分支静脉阻塞继发黄斑水肿的疗效及安全性。方法将2014年7月~2015年7月在梅州市人民医院确诊为视网膜分支静脉阻塞继发黄斑水肿的患者32例(32眼)纳入研究,随机将其分为2组:单纯光凝组16眼,行黄斑区格栅样光凝并给予复方血栓通胶囊药物;联合治疗组16眼,先行玻璃体腔内注射雷珠单抗0.05 ml/0.5 mg,同时给予复方血栓通胶囊药物,并于注药1周后行黄斑区格栅样光凝。所有患者均随访6个月,对比分析两组患者治疗前和治疗后1、3、6个月时采用糖尿病视网膜病变早期治疗研究(ETDRS)检查的最佳矫正视力(BCVA)及黄斑区中心凹厚度(CMT)变化情况以及有关眼部和全身不良反应发生情况。结果单纯光凝组治疗前的ETDRS视力平均为(21.8±8.63)个字母,治疗后1、3、6个月的视力分别为(33.5±9.76)、(31.6±9.96)、(30.5±8.83)个字母,与治疗前比较差异有统计学意义(P0.05)。联合治疗组治疗前的视力平均为(21.4±9.12)个字母,治疗后1、3、6个月的视力分别为(40.4±10.01)、(39.8±9.91)、(39.6±9.24)个字母,与治疗前比较视力明显提高,差异有统计学意义(P0.05)。单纯光凝组治疗前的CMT平均为(549.2±120.4)μm,治疗后1、3、6个月的CMT分别为(290.3±88.6)、(268.9±78.5)、(252.4±66.3)μm,与治疗前比较差异有统计学意义(P0.05)。联合治疗组治疗前的CMT平均为(550.6±114.8)μm,治疗后1、3、6个月的CMT分别为(206.2±54.7)、(190.1±53.8)、(180.5±34.6)μm,与治疗前比较CMT明显降低,差异有统计学意义(P0.05)。治疗后1、3、6个月联合治疗组视力和CMT均优于单纯光凝组(P0.05)。随访过程中未发现有关眼部及全身不良反应。结论玻璃体腔注射雷珠单抗联合黄斑区格栅样光凝治疗视网膜分支静脉阻塞继发黄斑水肿安全有效,可以显著提高视力,联合治疗的疗效明显优于单纯光凝治疗。
[Abstract]:Objective to observe the efficacy and safety of vitreous injection of Leizhu McAb combined with macular grid like photocoagulation in the treatment of macular edema secondary to retinal branch vein occlusion. Methods from July 2014 to July 2015, 32 patients (32 eyes) with macular edema secondary to retinal branch vein occlusion in Meizhou people's Hospital were randomly divided into two groups: 16 eyes in photocoagulation group, 16 eyes in photocoagulation group. In the combination group, 16 eyes were treated with intravitreous injection of Lei Zhu McAb (0.05 ml/0.5 mg), and 1 week after injection with compound Xueshuantong capsule, and 1 week after injection, the patients in the combined treatment group were treated with the gel gel photocoagulation in the macular area (n = 16), and in the treatment group (n = 16), intravitreous injection of Lei Zhu McAb (0. 05 ml/0.5 mg) was performed at the same time. All patients were followed up for 6 months. Comparative analysis of BCVA (best corrected visual acuity) and CMT (central foveal thickness of macular area) in patients with diabetic retinopathy before treatment and at 1: 3 and 6 months after treatment with early treatment of diabetic retinopathy Good reactions occur. Results the average visual acuity of ETDRS was 21.8 卤8.63 letters before treatment in the simple photocoagulation group, and 33.5 卤9.76 卤9.96 卤30.5 卤8.83 letters at 1 and 6 months after treatment, respectively. There was significant difference between the two groups before and after treatment (P 0.05). The average visual acuity of the combined treatment group was 21.4 卤9.12 letters before treatment, and 40.4 卤10.01 卤9.91 卤39.6 卤9.24 letters at 1 and 6 months after treatment, respectively. The visual acuity of the combined treatment group was significantly improved compared with that before treatment (P 0.05). The average CMT of the photocoagulation group was 549.2 卤120.4 渭 m before treatment, and the CMT was 290.3 卤88.6,268.9 卤78.5 卤252.4 卤66.3 渭 m at 1 and 6 months after treatment, respectively. There was a significant difference between the two groups before and after treatment (P 0.05). The average CMT of the combined treatment group was 550.6 卤114.8 渭 m before treatment, and the CMT of the combined treatment group was 190.1 卤53.8 卤180.5 卤34.6 渭 m at 1 and 6 months after treatment, respectively. The CMT was significantly lower than that before treatment (P 0.05). The visual acuity and CMT of the combined treatment group were better than that of the photocoagulation group (P 0.05) 1 and 6 months after treatment. No eye or systemic adverse reactions were found during follow-up. Conclusion it is safe and effective to treat macular edema secondary to retinal branch vein occlusion by intravitreal injection of Leizhu McAb combined with grid photocoagulation in macular area. The combined therapy is more effective than photocoagulation alone in the treatment of macular edema secondary to retinal branch vein occlusion.
【作者单位】：广东省梅州市人民医院眼科;
【分类号】：R774.5

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