贝伐单抗（Bevacizumab）治疗视网膜静脉阻塞继发黄斑水肿疗效的研究

发布时间：2018-03-19 14:04

本文选题：Bevacizumab/贝伐单抗　切入点：视网膜静脉阻塞　出处：《滨州医学院》2011年硕士论文　论文类型：学位论文

【摘要】：目的评估玻璃体腔注射贝伐单抗(Bevacizumab)治疗视网膜静脉阻塞(retinal vein occlusion. RVO)(?)发黄斑水肿(macular edema,ME)(?)的疗效,并观察早期眼压的变化。方法经间接检眼镜、荧光素眼底血管造影(fluorescein fundus angiography, FFA)、三维光学相干断层扫描(three-dimensional optical coherence tomography,3D-OCT)等检查确诊为RVO继发ME的患者共49例(49眼),分为试验组和对照组,两组均给予常规药物治疗,试验组玻璃体腔注射Bevacizumab,观察两组治疗前与治疗后1W、1m、3m、6m(?)勺最佳矫正视力(best-corrected visual acuity, BCVA).H眼压(intraocular pressure, IOP)、3D-OCT检测的黄斑中心凹厚度(central macular thickness,CMT)的变化。试验组又分为视网膜分支静脉阻塞(branch retinal vein occlusion, BRVO)继发的ME组(BRVO组)和视网膜中央静脉阻塞(central retinal vein occlusion,CRVO)继发的ME组(CRVO组),比较两组疗效的差别。试验组术后0.5h、1h、1.5h、2h(?)及1d非接触眼压计(Topcon-80)检测IOP。结果试验组术后1w、1m、3m、6m BCVA分别是(0.43±0.20、0.47±0.30、0.41±0.32、0.344±0.34),与术前相比(0.24±0.20)差异均有统计学意义(P0.05)。试验组术后1w、1m、3m、6m CMT分别是(313±55μm、325±101μm、360±117μm、396±143μm),与术前CMT(500±141μm)相比差异均有统计学意义(P0.05)。对照组治疗后1w、1m、3m、6m BCVA分别是(0.28±0.19、0.29±0.21、0.27±0.27、0.25±0.26),与术前BCVA(0.25±0.20)相比差异无统计学意义。对照组治疗后1w、1m、3m、6m CMT分别是(446±117μm、427±119μm、433±118μm、449±122μm)与术前CMT(457±128μm)相比差异均无统计学意义。试验组治疗后1w、1m、3m、6m BCVA、CMT与对照组相应时间点相比差异均有统计学意义(P0.05)。BRVO组在治疗后1m BCVA(0.54±0.23)达最佳视力,且此时黄斑水肿(292±50μm)改善也最明显。而CRVO组1wBCVA(0.37±0.32)达治疗后最佳视力,CMT (324±56μm)降低最显著。以治疗后3m、6m BCVA作为疗效评估标准,玻璃体腔注射Bevacizumab治疗CRVO、BRVO继发黄斑水肿的疗效差异无统计学意义(P=0.702,0.714)。试验组术后平均峰值眼压(19.72±8.19mmHg)出现在术后0.5h,与术前(15.35±2.51mmHg)相比差异有统计学意义(P0.05),术后1d时平均眼压为(16.17±3.17mmHg),与术前相比差异无统计学意义。随访中未见与注射及药物有关的眼部和全身不良反应。结论玻璃体腔注射Bevacizumab治疗RVO继发的黄斑水肿疗效显著,并发症少。无论是BRVO抑或CRVO,贝伐单抗治疗黄斑水肿的疗效无明显差别。玻璃体腔注射Bevacizumab治疗早期可能会出现一过性眼压增高,但24h内均能恢复至正常范围。
[Abstract]:Objective to evaluate the effect of intravitreal injection of bevacizumab (Bevacizumab) in the treatment of retinal vein occlusion. Macular Edema macular Edema. And to observe the change of intraocular pressure in early stage. Methods 49 cases (49 eyes) with secondary ME of RVO were examined by indirect ophthalmoscope, fluorescein fundus angiography (FFAA) and three-dimensional optical coherence tomphography (3D-OCTT). The patients were divided into two groups: experimental group and control group. Both groups were given routine drug therapy. Bevacizumab was injected into the vitreous cavity of the experimental group. Best corrected visual acuity, BCVA).H intraocular pressure, IOP 3D-Oct measured macular central foveal thickness and central macular thicknessen CMT.The trial group was divided into branch retinal vein occlusion branch retinal vein occlusion (BRVO-secondary ME group) and central retinal vein group (BRVO group). The difference of the curative effect between the two groups was compared between the ME group and CRVO group, which was secondary to central retinal vein inclusion (CRVO). ) and 1 d non-contact intraocular pressure meter Topcon-80) were used to detect IOP. Results the results showed that there were significant differences between the test group (0.43 卤0.20) 0.47 卤0.32 (0.44 卤0.34) and the control group (0.24 卤0.20) at 1 week after operation (P 0.05), and the CMT of the test group was 313 卤55 渭 m ~ (3) m ~ (6) CMT, which was 313 卤55 渭 m ~ (325 卤101) 渭 m ~ (360 卤117) 渭 m ~ (396 卤143) 渭 m compared with preoperative CMT(500 卤141 渭 m, respectively, and the difference between the control group and the control group was 0.28 卤0.19 0 卤0.21 0 卤0.27 卤0.27 卤0.27 卤0.27 卤0.26 卤0.26 渭 m, respectively, compared with that of preoperative CMT(500 卤141 渭 m. There was no significant difference in preoperative BCVA(0.25 卤0.20. There was no significant difference between the control group (446 卤117 渭 m) and the control group (446 卤117 渭 m, 443 卤118 渭 m) and the control group (CMT(457 卤128渭 m) 1 week after treatment. There was significant difference between the experimental group and the control group at 1 week after treatment. The best visual acuity was obtained in the P0.05 + BRVO group (1 BCVA(0.54 卤0.23) after treatment. The improvement of macular edema was also the most obvious at this time, while in the CRVO group, the best visual acuity was significantly decreased after 1 ww BCVA (0.37 卤0.32) and the best visual acuity was 324 卤56 渭 m). There was no significant difference in the efficacy of intravitreal injection of Bevacizumab in the treatment of macular edema secondary to CRVO BRVO. The mean peak intraocular pressure (IOP) of the experimental group was 19.72 卤8.19mmHg at 0.5 h after operation, which was significantly higher than that of pre-operation (15.35 卤2.51mmHg). There was no significant difference between the two groups. There were no ocular and systemic adverse reactions associated with injection and drug administration during the follow-up. Conclusion the effect of intravitreal injection of Bevacizumab on macular edema secondary to RVO is significant. There was no significant difference in the efficacy of bevacizumab in the treatment of macular edema whether it was BRVO or CRVO.Intravitreal injection of Bevacizumab might lead to a transient increase in intraocular pressure at the early stage, but it could recover to normal range within 24 hours.
【学位授予单位】：滨州医学院
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R774

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