湿性老年性黄斑变性病人视网膜血流的变化对预后判定的指导价值  

The value of the retinal blood flow change in evaluating the prognosis of patients with wet age-related macular degeneration

作　　者：周云[1] 王娜娜[1] 周霞[1] 冯敏[1] ZHOU Yun;WANG Na-na;ZHOU Xia;FENG Min(Department of Ophthalmology,Taihe Hospital of Shiyan,Shiyan Hubei 442000,China)

机构地区：[1]湖北省十堰市太和医院眼科,442000

出　　处：《蚌埠医学院学报》2019年第1期51-53,57,共4页Journal of Bengbu Medical College

摘　　要：目的:探讨湿性老年性黄斑变性病人视网膜血流的变化对预后判定的指导价值。方法:选择湿性老年性黄斑变性病人72例(72眼)作为观察组,同期选择健康体检的老年人72名(72眼)作为对照组,对照组在体检时进行视网膜血流检测;观察组均给予玻璃体腔注射曲雷珠单抗治疗,在治疗前后进行视网膜血流的超声检测,观察预后情况。结果:观察组治疗后患眼动脉和视网膜中央动脉的舒张末期血流速度和收缩期峰值血流速度均明显高于治疗前(P<0.05～P<0.01),与对照组比较差异均无统计学意义(P>0.05);观察组治疗前后的阻力指数与对照组比较差异均无统计学意义(P>0.05)。观察组治疗后的最佳矫正视力明显好于治疗前(P<0.01);治疗期间的并发症发生率为6.9%,经过对症处理后均好转。直线相关分析显示患眼动脉和视网膜中央动脉的舒张末期血流速度和收缩期峰值血流速度均与预后视力状况呈负相关关系(P<0.05)。结论:湿性老年性黄斑变性病人视网膜的血流速度均明显降低,雷珠单抗注射液的应用治疗能有效改善视力与视网膜血流状况,同时视网膜的血流速度变化对病人疗效评估具有较重要的临床价值。Objective:To investigate the value of the retinal blood flow change in evaluating the prognosis of patients with wet age-related macular degeneration.Methods:Seventy-two patients with wet age-related macular degeneration(72 eyes)and 72 healthy elderly(72 eyes)were divided into the observation group and control group,respectively.The vitreous chamber in observation group was injected with ranibizumab.The retinal blood flow levels in observation group before and after treatment,which in control group were observed using the ultrasound the physical examination.Results:The diastolic velocity and peak systolic velocity of ophthalmic artery and central retinal artery in observation group after treatment were significantly higher than before treatment(P<0.05 to P<0.01),and the difference of which between two groups was not statistically significant(P>0.05).The differences between the resistance index in observation group before and after treatment,and resistance index in control group were not statistically significant(P>0.05).The best corrected visual acuity in observation group after treatment was significantly better than before treatment(P<0.01).The incidence rate of complications during treatment was 6.9%,and the complication was improved after symptomatic treatment.Linear correlation analysis showed that the diastolic velocity,peak systolic velocity of ophthalmic artery and central retinal artery were negatively correlated with the vision of prognosis(P<0.05).Conclusions:The retinal blood flow velocity in patients with wet age-related macular degeneration significantly decreases,the ranibizumab injection can effectively improve the vision and retinal blood flow of patients,and the change of retinal blood flow velocity has an important value on assessing the prognosis of patients in clinic.

关 键 词：黄斑变性 视网膜中央动脉 舒张末期血流速度 收缩期峰值血流速度 

分 类 号：R774.5[医药卫生—眼科]