雷珠单抗治疗老年人角膜新生血管的临床疗效  

Clinical efficacy of ranibizumab in the treatment of corneal neovascularization in elderly patients

作　　者：黄玉庚 王铜亮[3] 王涛 朱永洁 

机构地区：[1]浙江省宁波市鄞州区第二医院眼科,315100 [2]浙江省宁波市鄞州区第二医院儿科,315100 [3]浙江省宁波市第一医院眼科,315000 [4]浙江省舟山市广安医院眼科,316100

出　　处：《中华老年医学杂志》2017年第6期683-686,共4页Chinese Journal of Geriatrics

摘　　要：目的评价雷珠单抗治疗老年人角膜新生血管（CNV）的临床疗效和安全性。方法共纳入CNV老年患者40例（50只眼），以2015年1—12月的20例患者（22只眼）为观察组，给予结膜下注射雷珠单抗治疗；以2014年6—12月的20例患者（28只眼）为对照组，给予激光光凝术治疗；比较两组患者治疗前和治疗后1个月、6个月和12个月视力、CNV面积、眼压和治疗有效率，治疗后随访12个月记录患者有无复发和并发症情况。结果治疗后1个月，观察组视力测试提高1行以上者为20只眼（90．9％），明显高于对照组16只眼（57．1％）（χ^2=6．910、P=0．031）；治疗后6个月，观察组视力测试提高1行以上者为19只眼（86．3％），明显高于对照组14只眼（50．0％）（χ^2=5．866、P=0．020）；治疗后12个月，观察组视力测试提高1行以上者为19只眼（86．3％），明显高于对照组12只眼（42．9％）（χ^2=8．010、P=0．016）。观察组和对照组治疗后CNV面积均较治疗前减少，且观察组治疗后1个月、6个月和12个月CNV面积均明显小于对照组，差异均有统计学意义（t=6．109、5．291、8.330，P=0．019、0．033、0．009）。观察组和对照组治疗前后眼压变化差异无统计学意义（均P〉0．05）。观察组治疗有效率为90．9％（20／22），明显高于对照组75．0％（21／28）（χ^2=6．109、P=0．006）。术后随访12个月结果显示，对照组中有7只眼（25．0％）出现新生血管复发，明显高于观察组2只眼（9．1％）（χ^2=8．668、P=0．003）。结论结膜下注射雷珠单抗治疗老年人CNV安全有效，并发症少，可在临床上推广应用。Objective To evaluate the clinical efficacy and safety of ranibizumab in the treatment of corneal neovascularization（CNV）in elderly patients. Methods A total of 40 elderly patients（50 eyes）with conceal neovascularization were enrolled in this study at our hospital. Among them, 20 patients（22 eyes）in observation group enrolled from January 2015 to December 2015, received subconjunctival injection of ranibizumab,and 20 patients （28 eyes） in control group enrolled from June 2014 to December 2014, receivedlaser photocoagulation. The visual acuity, the area of corneal neovascularization, intraocular pressure and therapeutic response rate were measured and compared between two groups before and 1 month, 6 months and 12 months after treatment. All patients were followed up for 12 months to record the recurrence and complications. Results In the observation group,20 eyes（90.9%）,19 eyes（86.3%）and 19eyes（86.3%）got an improved eyesight at 1 month,6 months and 12 months of ranibizt/mab treatment, respectively, which were significantly higher than those in the control group（ 16/57. 1%,14/50.0%, 12/42.9%,χ^2 = 6. 910,5. 866,8. 010;P= 0. 031, 0. 020,0. 016, respectively）. The area of corneal neovascularization was decreased in both groups after treatment in the Comparison of pretreatment. What is more important： at 1 month, 6 months and 12 months of treatment,the areas of CNV were all significantly smaller in the observation group than in the control group （t = 6. 109, 5. 291,8. 3303 P = 0. 019,0. 033,0. 009, respectively）. There was no significant difference in intraocular pressure before versus after treatment in both groups （both P〉 0.05）. The therapeutic response rate was 90.9% （20/22） in observation group, and 75.0% （21/28） in control group（χ^2= 6. 109,P=0. 006）. During the 12 month follow up after operation, the recurrence rate of CNV was significantly higher in control group（7 eyes, 25.0%）than in observation group（2 eyes,9. 1%）（χ^2= 8. 668,P= 0.003）.

关 键 词：角膜新生血管化 血管内皮生长因子类 

分 类 号：R772.2[医药卫生—眼科]