雷珠单抗联合玻璃体切除术治疗严重增生型糖尿病视网膜病变  

Treatment of severe proliferative diabetic retinopathy with Ranibizumab injection and vitrectomy

作　　者：杨平[1] 付立红[1] 魏菁[1] 王怡[1] 雷方[2] 

机构地区：[1]河南科技大学临床医学院河南科技大学第一附属医院眼科,洛阳471003 [2]河南科技大学,洛阳

出　　处：《中华眼外伤职业眼病杂志》2017年第7期530-533,共4页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的评价雷珠单抗玻璃体内注射联合玻璃体切除术治疗严重增生型糖尿病视网膜病变（PDR）的临床效果及安全性。方法采取回顾性分析方法，严重PDR32例（40眼）为试验组，玻璃体内注射雷珠单抗0．5mg，3d后进行玻璃体切除术。同期30例（38眼）为对照组，直接进行玻璃体切除术。术后随访，对比两组患者黄斑中心区视网膜厚度（CMT）、视力、眼压及术后并发症情况。结果试验组术前视力（10gMAR，BCVA）为1．40±0．03，CMT为（353．7±32．6）μm；术后1个月分别为1．00±0．04、310．2±28．7μm。对照组术前视力为1．40±0．04，CMT为（352．9±35．1）μm；术后1个月分别为1．20±0．04、（326．7±25．6）μm。两组术前视力及CMT差异无统计学（t=0．00，0．10；P=1．00，0．92），而术后试验组视力及CMT均优于对照组（t=-22．07，-2．67；P=0．00，0．01）。两组患者手术前后眼压差异无统计学意义（t=-0．43，-0．72；P=-0．67，0．47）。试验组术后玻璃体积血发生率低于对照组（χ2=4．72，P=0．03）。结论玻璃体切除术联合雷珠单抗玻璃体内注射可有效提高严重PDR患者视力，降低CMT，减少术后并发症。Objective To evaluate the clinical efficacy and security of Ranibizumab intravitreal injection and vitrectomy for severe proliferative diabetic retinopathy （PDR）. Methods Forty eyes of 32 cases with severe PDR were selected and analyzed retrospectively as the trial group, and they received intravitreal injection of 0.5 mg Ranibizumab before 3 days vitrectomy. Thirty-eight eyes of 30 cases with PDR in same period were selected as control group, and they received vitrectomy only. The central macular retinal thickness（CMT） , visual acuity, intraocular pressure and complications were observed and compared during the follow-up. Results The visual acuity （ log MAR, BCVA ） was 1.40 ± 0. 03, the CMT was （353.7 ±32.6）μm before surgery in trial group, and 1.00 ±0.04, （310.2± 28.7） μm at 1 month after surgery, respectively. The visual acuity was 1.40 ± 0.04, the CMT was （ 352.9± 35.1 ） μm before surgery in control group, and 1.20 ± 0.04, （ 326.7 ±25.6）μm at 1 month after surgery, respectively. There was no significant difference in visual acuity or CMT between the two groups before surgery（ t = 0.00, 0. 10 ; P = 1.00, 0.92 ）. The visual acuity and CMT in the trial group were better than those in the control group after operation（ t = - 22.07, - 2.67 ; P = 0.00,0.01 ）. There was no statistical difference in intraocular pressure between the two groups before and after operation （ t = - 0.43, - 0.72; P = - 0.67,0.47 ） , but the incidence rate of vitreous hemorrhage in trial group was lower than that of control group （χ2 = 4.72, P =0.03 ）. Conclusion Ranibizumab injection and vitrectomy can effectively improve the visual acuity, reduce CMT and complications of severe PDR.

关 键 词：视网膜病变 糖尿病性 增生性 严重 雷珠单抗 玻璃体内注射 玻璃体切除术 

分 类 号：R587.2[医药卫生—内分泌] R779.6[医药卫生—内科学]