玻璃体内注射雷珠单抗联合玻璃体切割术治疗严重增生型糖尿病视网膜病变

发布时间：2018-08-05 15:09

【摘要】：目的观察玻璃体内注射雷珠单抗联合玻璃体切割术治疗严重增生型糖尿病视网膜病变(proliferative diabetic retinopathy,PDR)的临床效果。方法将临床确诊为严重PDR的患者52例72眼纳入本研究。依据术前是否行玻璃体内注射雷珠单抗将患者分为治疗组和对照组:治疗组30例42眼、对照组22例30眼。治疗组术前3 d玻璃体内注射10 g·L-1雷珠单抗0.05 mL(0.5 mg),然后行玻璃体切割术,对照组直接行玻璃体切割术。术后随访3~12(6.5±1.3)个月。对比分析两组患者视力、眼压、黄斑中心凹视网膜厚度和术后并发症的发生情况。结果治疗组、对照组手术后视力分别为0.090±0.068、0.060±0.029,均较术前提高,2组治疗前、治疗后视力比较差异均有统计学意义(t=-5.005、-3.237,均为P0.05)。两组术后视力比较,差异有统计学意义(t=2.034,P0.05)。治疗组、对照组术后黄斑中心凹视网膜厚度分别为(313.8±27.3)μm、(325.6±14.5)μm,差异有统计学意义(t=-1.51,P0.05)。术后2周、1个月、3个月,治疗组玻璃体积血发生率分别为12%、2%、2%,对照组发生率分别为27%、20%、3%;两组术后各时间点发生率比较,术后2周及1个月之间差异均有统计学意义(χ2=3.42、3.21,均为P0.05),术后3个月差异无统计学意义(χ2=1.02,P0.05)。结论玻璃体切割术联合玻璃体内注射雷珠单抗治疗严重PDR能提高患者视力,降低术后玻璃体积血发生率和黄斑中心凹视网膜厚度。
[Abstract]:Objective to observe the clinical effect of intravitreous injection of Leizhu monoclonal antibody combined with vitrectomy in the treatment of severe proliferative diabetic retinopathy (proliferative diabetic retinopathy). Methods 52 cases (72 eyes) with severe PDR were included in this study. The patients were divided into treatment group (n = 30) and control group (n = 42) according to whether intravitreous injection of Lei Zhu McAb was performed before operation: treatment group (n = 30) and control group (n = 22) (30 eyes). The treatment group was treated with vitrectomy 3 days before operation, and the control group was directly treated with vitrectomy. The treatment group was injected with 10 g L -1 Lei Zhu McAb 0. 05 mL (0. 5 mg),) and the control group was directly treated with vitrectomy. Postoperative follow-up was 3 weeks (6.5 卤1.3) months. Visual acuity, intraocular pressure, macular central foveal retinal thickness and postoperative complications were compared between the two groups. Results the visual acuity of the treatment group and the control group were 0.090 卤0.068 and 0.060 卤0.029, respectively, which were significantly higher than those of the two groups before and after treatment (tng-5.005- 3.237, P0.05). The postoperative visual acuity of the two groups was significantly different (t = 2.034 P 0.05). The retinal thickness of macular fovea was (313.8 卤27.3) 渭 m and (325.6 卤14.5) 渭 m in the treatment group and control group, respectively. At 2 weeks, 1 month, 3 months after operation, the incidence of vitreous hemorrhage in the treatment group was 12 and that in the control group was 27. 20 and 3, respectively. The difference between 2 weeks and 1 month after operation was statistically significant (蠂 2 + 3.42 卤3. 21, P0.05), but there was no significant difference 3 months after operation (蠂 2 + 1. 02 P 0.05). Conclusion vitrectomy combined with intravitreous injection of Lei Zhu McAb can improve the visual acuity and decrease the incidence of vitreous hemorrhage and retinal thickness of macular central fovea in patients with severe PDR.
【作者单位】：石河子大学医学院第一附属医院眼科;
【基金】：石河子大学医学院第一附属医院院级课题(编号:YL2010-Y003)~~
【分类号】：R779.6;R587.2

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