玻璃体内注射雷珠单抗与曲安奈德治疗糖尿病黄斑水肿的疗效对比分析

发布时间：2018-12-06 08:33

【摘要】：目的对比分析玻璃体内注射雷珠单抗与曲安奈德治疗糖尿病黄斑水肿的临床疗效。方法选取就诊于我院眼科的糖尿病黄斑水肿患者47例(48眼),病程6~14个月;分为雷珠单抗组24例24眼,曲安奈德组23例24眼;分别给予玻璃体内注射雷珠单抗0.05 mL与曲安奈德0.05 mg,比较两组治疗1周、1个月、3个月、6个月患眼的最佳矫正视力、黄斑中心凹视网膜厚度、眼压及眼底黄斑区荧光素渗漏情况,观察治疗后的效果。结果雷珠单抗组与曲安奈德组治疗后1周、1个月、3个月患眼的最佳矫正视力均得到提高,分别为0.08±0.02与0.06±0.03、0.21±0.03与0.17±0.05、0.29±0.07与0.27±0.04,治疗后短期内两组间差异无统计学意义(P值分别为0.082、0.092、0.320);治疗6个月后,曲安奈德组患眼的最佳矫正视力(0.18±0.03)有5例出现回降现象;而雷珠单抗组患眼的最佳矫正视力(0.28±0.09)变化趋于稳定,两组间的差异有统计学意义(P=0.003)。治疗后1周、1个月、3个月、6个月雷珠单抗组与曲安奈德组患眼的黄斑中心凹视网膜厚度分别为(336.00±94.71)μm与(378.00±89.74)μm、(251.00±63.55)μm与(273.00±81.29)μm、(263.00±59.42)μm与(267.00±49.32)μm、(238.00±42.61)μm与(298.00±33.27)μm,治疗后各时间点两组间的差异均无统计学意义(P=0.127、0.071、0.053、0.058)。另外,治疗后各时间点两组的眼压均在正常范围内,并且黄斑区荧光渗漏均无明显增强现象。结论玻璃体内注射雷珠单抗和曲安奈德治疗糖尿病黄斑水肿,均能有效控制糖尿病视网膜病变患者病情发展并能改善视力。两种疗法的疗效在短期内差异无统计学意义,治疗6个月后,雷珠单抗疗效的稳定性优于曲安奈德。
[Abstract]:Objective to compare the clinical effects of intravitreous injection of Lei Zhu McAb and triamcinolone acetonide on diabetic macular edema. Methods Forty-seven patients (48 eyes) with diabetic macular edema in ophthalmology of our hospital were divided into two groups: 24 cases (24 eyes) with triamcinolone acetonide group (24 cases) and 24 eyes (24 eyes) with triamcinolone acetonide group (23 cases). The best corrected visual acuity (BCVA) and retinal thickness of central fovea of macula were compared with triamcinolone acetonide for 1 week, 1 month, 3 months and 6 months after intravitreous injection of Lei Zhu monoclonal antibody (0. 05 mL) and triamcinolone acetonide (0. 05 mg,). Intraocular pressure and fundus fluorescein leakage were observed after treatment. Results the best corrected visual acuity (BCVA) of the eyes in the Leizhu McAb group and triamcinolone acetonide group were improved 1 week, 1 month and 3 months after treatment, respectively, and were 0.08 卤0.02 and 0.06 卤0.03 0.21 卤0.03 and 0.17 卤0.05U 0.29 卤0.07 and 0.27 卤0.04, respectively. There was no significant difference between the two groups in the short term after treatment (P = 0.082, 0.092, 0.320, respectively). After 6 months of treatment, the best corrected visual acuity (BCVA) in triamcinolone acetonide group (0.18 卤0.03) was found in 5 cases. However, the change of the best corrected visual acuity (BCVA) in the Lei Zhu McAb group (0.28 卤0.09) tended to be stable, and the difference between the two groups was statistically significant (P0. 003). The retinal thickness of macular fovea was (336.00 卤94.71) 渭 m and (378.00 卤89.74) 渭 m in Lei Zhu McAb group and triamcinolone acetonide group at 1 week, 1 month, 3 months and 6 months after treatment, respectively. (251.00 卤63.55) 渭 m and (273.00 卤81.29) 渭 m, (263.00 卤59.42) 渭 m and (267.00 卤49.32) 渭 m, (238.00 卤42.61) 渭 m and (298.00 卤33.27) 渭 m, respectively. There was no significant difference between the two groups at each time point after treatment (P < 0. 127, 0. 071, 0. 053, 0. 058). In addition, intraocular pressure was within normal range at each time point after treatment, and fluorescence leakage in macular area was not significantly enhanced. Conclusion intravitreal injection of Leizhu McAb and triamcinolone acetonide in the treatment of diabetic macular edema can effectively control the development of diabetic retinopathy and improve visual acuity. There was no significant difference between the two treatments in the short term. After 6 months of treatment, the stability of triamcinolone acetonide was better than that of triamcinolone acetonide.
【作者单位】：南方医科大学南方医院眼科;南方医科大学南方医院惠侨科;
【基金】：广东省自然科学基金编号:S2012010008946;S20130100664)~~
【分类号】：R587.2;R774.5

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