卵磷脂络合碘片辅助雷珠单抗联合激光光凝治疗黄斑水肿临床观察  

Clinical study of iodized lecithin tablets in the adjunctive ranibizumab combined with laser photocoagulation treatment of macular edema

作　　者：裴晗[1,2] 郑一晨 张新法[2] 石慧[2] 贺恒[2] 马思琪[2] 李斌[2] 

机构地区：[1]河南省眼科研究所河南省立眼科医院郑州大学人民医院,郑州450003 [2]华中科技大学同济医学院同济医院眼科,武汉430030

出　　处：《中国实用眼科杂志》2016年第1期27-31,共5页Chinese Journal of Practical Ophthalmology

摘　　要：目的观察卵磷脂络合碘片辅助雷珠单抗联合激光光凝治疗黄斑水肿的临床疗效。方法前瞻性随机对照研究。对2014年1月至2015年1月在华中科技大学附属同济医院眼科就诊的62例（62只眼）不同原因引起的黄斑水肿病人应用数字表法随机分为两组：卵磷脂络合碘组31例（31只眼），雷珠单抗玻璃体腔注射联合视网膜激光光凝后辅以卵磷脂络合碘片口服治疗，每次3mg，每日3次，共4周；对照组31例（31只眼），雷珠单抗玻璃体腔注射联合视网膜激光光凝，但不接受碘剂；在治疗后1周、2周、4周观察最佳矫正视力（BCVA）、黄斑中心区视网膜厚度（CMT）和黄斑区硬性渗出分级的变化情况。结果卵磷脂络合碘组和对照组在治疗1周（Z=1．275，P=0．202）和2周（Z=0．984，P=0．325）时最佳矫正视力BCVA（LogMAR）相比较，差异无统计学意义，4周时卵磷脂络合碘组BCVA平均值为（0．52±0．24）logMAR，对照组为（0．69±0．33）logMAR，差异有统计学意义（Z=2．082，P=0．037）。黄斑中心区视网膜厚度（CMT）两组在1周时相比较差异无统计学意义（Z=0．901，P=0．368）；2周时卵磷脂络合碘组CMT平均值为（304．94±101．06）μm，对照组为（378．60±133．69）μm，差异有统计学意义（Z 2．035，P=0．042）；4周时卵磷脂络合碘组为（213．03±68．33）μm，对照组为（254．74±74．37）μm，差异有统计学意义（Z=2．239，P=0.025）。1周（Х^2=0．350，P=0．554）和2周（Х^2=1．958，P=0．162）时卯磷脂络合碘组和对照组在硬性渗出减少的发生率方面差异无统计学意义；4周时卵磷脂络合碘组和对照组两组硬性渗出减少发生率分别为32．26％和9．68％，差异有统计学意义（Х^2=4．769，P=0．029）。结论卵磷脂络合碘对于不同原因引起的黄斑水肿具有改善视力、减轻水肿程度和促进硬性渗出吸收的作用，可作�Objective To determine the clinical efficacy of iodized lecithin tablets as the adjunctive ranibizumab combined with laser photocoagulation treatment for macular edema, Methods Prospective randomized controlled study. A total of 62 consecutive patients （62 eyes） suffered from macular edema accepted intravitreal ranibizumab combined with laser photocoagulation in advance. The cases were divided into two groups： 31 cases were treated with iodized lecithin tablets 3mg every time, three times per day, totally for four weeks, the other 31 cases in control group received no iodized lecithin tablets. The outcome measurements were status of best corrected visual acuity （BCVA）, central macular thickness （CMT） and hard exudates grading at 1 week, 2 weeks and 4 weeks after therapy. Results There were no significant differences in logarithm of minimum angle of resolution （LogMAR） BCVA at 1 week （Z =1.275, P =0.202） and 2 weeks （Z =0.984, P =0.325） after treatment between two groups, but the average LogMAR BCVA was 0.52±0.24 and 0.69±0.33 respectively at 4 weeks, with the significant difference （Z =2.082, P =0.037）. No significant differences were found between two groups for CMT at 1 week after treatment （Z =0.901, P =0.368）. The average CMT was （304.94±101.06）μm and （213.03±68.33）μm in iodized lecithin tablets group at 2 weeks and 4 weeks respectively after therapy, while the control was （378.60±133.69）gm and （254.74± 74.37）gm respectively. The CMT in iodized lecithin tablets group were thinner than control group at 2 weeks （Z =2.035, P =0.042） and 4 weeks （Z =2.239, P =0.025） after treatment. There were no significant differences in the incidence of hard exudates reduction at 1 week （Х^2 =0.350, P =0.554） and 2 weeks （Х^2=1.958, P =0.162） after treatment. The average incidence of hard exudates reduction was 32.26% and 9.68% respectively at 4 weeks after therapy, which was statistically significant （Х^2= 4.769, P =0.029）. Conclusions Iodized le

关 键 词：卵磷脂络合碘 雷珠单抗 激光光凝 黄斑水肿 

分 类 号：R771[医药卫生—眼科]