玻璃体腔注射Lucentis治疗糖尿病性黄斑水肿的临床观察

发布时间：2018-06-11 19:14

本文选题：Lucentis + 玻璃体腔注射　；参考：《中南大学》2011年硕士论文

【摘要】：目的：观察Lucentis应用于糖尿病黄斑水肿的临床疗效,并评价其整体安全性。方法：根据标准入组30例30眼糖尿病黄斑水肿患者,双盲随机分为单一治疗组、联合治疗组和激光对照组,接受12个月的治疗,每月复查一次,观察最佳矫正视力(Best corrected visual acuity, BCVA)、眼前节、眼压、眼底以及中央黄斑厚度(central macular thickness, CMT)和荧光眼底血管造影(FFA)的变化。其中单一治疗组：Lucentis0.5mg玻璃体腔注射；联合治疗组：Lucentis0.5mg玻璃体腔注射联合黄斑区局部／格栅样激光光凝；激光对照组：传统的黄斑区局部或格栅样激光光凝术。联合组和激光对照组的激光治疗首次光凝可在两周内分两次完成,之后有必要时可进行再次光凝治疗,距离上次激光治疗至少3个月。结果： 1.单一治疗组和联合治疗组的平均BCVA从治疗第3月起至第12月均优于激光对照组,三组最终平均BCVA分数分别提高15.9±6.2个字母、提高16.3±6.7个字母和降低2.8±6.7个字母；单一组和联合组的最高平均BCVA分数分别出现在第7月和第6月,对照组在第一次治疗后平均BCVA分数提高,但在随后的随访中无明显变化。 2.单一组和联合组的平均CMT从第1月至第12月均明显优于对照组,最终三组CMT分别减少419.73±45.64μm、418.37±53.21μm和20.20±6.13μm；联合组的平均CMT在治疗后1月,3月明显优于单一组,但6月、9月、12月两组平均CMT无差异,且最佳平均CMT均出现在第6月,对照组在第一次激光治疗后平均CMT减少,在第6月最佳,但在随后的随访中无明显变化； 3.FFA检查,治疗前后黄斑区荧光渗漏发生例数三组比较,单一组和联合组明显优于对照组,三组分别降低90%、100%和20%,而联合组与单一组差异无统计学意义。 4.未观察到因玻璃体腔注药导致的白内障,感染性眼内炎、视网膜脱离、色素上皮撕裂、脉络膜脱离等并发症,三个组的患者在整个随访期间,未出现心脑血管方面的不良事件。结论： 1 Lucentis (0.5mg)单一治疗和联合激光治疗,对糖尿病黄斑水肿的控制以及对患者最佳矫正视力的提高优于单一激光治疗； 2对糖尿病黄斑水肿患者的治疗,Lucentis玻璃体腔注射与激光治疗有协同作用； 3玻璃体腔注射Lucentis可以作为糖尿病黄斑水肿的首选治疗； 4 Lucentis单一治疗或联合激光治疗应用于糖尿病黄斑水肿的整体安全性可靠。
[Abstract]:Objective: to observe the clinical efficacy of Lucentis in the treatment of diabetic macular edema and to evaluate its overall safety. Methods: 30 cases (30 eyes) of diabetic macular edema were randomly divided into two groups. The combined treatment group and the laser control group were treated for 12 months. The best corrected visual acuity (BCV), anterior segment, intraocular pressure, fundus, central macular thicknessand fluorescence fundus angiography (FFA) were observed. In the single treatment group, 1% Lucentis 0.5 mg intravitreous injection; in the combined treatment group, 1% Lucentis 0.5 mg intravitreous injection combined with macular area local / grid laser photocoagulation; in the laser control group, the traditional macular area local or grid laser photocoagulation was performed. The first photocoagulation of the combined group and the laser control group can be completed in two weeks, and then, if necessary, the laser therapy can be performed again, at least 3 months after the last laser therapy. Results: 1. The average BCVA of the single treatment group and the combined treatment group was better than that of the laser control group from the 3rd month to the 12th month. The final mean BCVA scores of the three groups were increased by 15.9 卤6.2 letters, 16.3 卤6.7 letters and 2.8 卤6.7 letters, respectively. The highest mean BCVA scores in the single group and the combined group were in the seventh and sixth months, respectively. The average BCVA scores in the control group increased after the first treatment, but there was no significant change in the follow-up. 2. The average CMT of the single group and the combined group was significantly better than that of the control group from the first month to the 12th month, the final CMT of the three groups decreased by 419.73 卤45.64 渭 m, 418.37 卤53.21 渭 m and 20.20 卤6.13 渭 m, respectively, and the average CMT of the combined group was significantly better than that of the single group at 1 month and 3 months after treatment. However, there was no difference in average CMT between the two groups in June, September and December, and the best average CMT appeared in the sixth month. In the control group, the mean CMT decreased after the first laser treatment, the best in the sixth month, but there was no significant change in the follow-up. 3. Compared with the control group, the single group and the combined group decreased 90% and 20%, respectively, but there was no significant difference between the combined group and the single group. 4. No complications such as cataract, infective endophthalmitis, retinal detachment, laceration of pigment epithelium, choroidal detachment were observed due to intravitreal injection. There were no adverse events in cardiovascular and cerebrovascular diseases. Conclusion: 1 Lucentis monotherapy and combined laser therapy, The control of diabetic macular edema and the improvement of the best corrected visual acuity of the patients were better than that of single laser therapy; 2 the treatment of diabetic macular edema patients with macular edema was synergistic with laser treatment; Lucentis can be used as the first choice of treatment for diabetic macular edema, and 4 Lucentis single therapy or combined laser therapy is safe and reliable for diabetic macular edema.
【学位授予单位】：中南大学
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R587.2;R774.5

【相似文献】