玻璃体腔注射雷珠单抗对老年PDR合并AMD患者的疗效研究  

Study on the effect of intravitreal injection of ranibizumab on elderly PDR combined with AMD

作　　者：张娴[1,2] SAM EMansour 施恩 ZHANG Xian;SAM EMansour;SHI En(Department of Ophthalmology,Ningbo Medical Center Lihuili Hospital,Ningbo,Zhejiang 315000,China;Department of Ophthalmology,Taipei Medical University Ningbo Medical Center,Ningbo,Zhejiang 315000,China;Department of Ophthalmology,The George Washington University Hospital,Washington D.C.20037,America;Virginia Retina Center,Virginia 20186,America)

机构地区：[1]浙江省宁波市医疗中心李惠利医院眼科,315000 [2]台北医学大学宁波医疗中心眼科,浙江宁波315000 [3]乔治华盛顿大学医院眼科,美国华盛顿哥伦比亚特区20037 [4]弗吉尼亚视网膜中心,美国弗吉尼亚州20186

出　　处：《重庆医学》2020年第2期188-191,196,共5页Chongqing medicine

基　　金：浙江省医药卫生科技计划项目（2018270516）

摘　　要：目的探究玻璃体腔注射雷珠单抗对老年增殖性糖尿病视网膜病变(PDR)合并老年性黄斑变性(AMD)的临床效果。方法选取2015年10月至2018年12月乔治华盛顿大学医院眼科和弗吉尼亚视网膜中心收治的87例老年PDR合并AMD患者,均行玻璃体腔注射雷珠单抗(0.5 mg)治疗,分别于治疗前和治疗后1个月采用视力表检测患者最佳矫正视力(BCVA),采用光学相干断层扫描测量黄斑中心凹厚度(CFT),采用超声诊断仪检查眼动脉(OA)和视网膜中央动脉(CRA)的收缩期峰值血流速度(PSV)和舒张末期血流速度(EDV),采用ELISA检测血管内皮生长因子(VEGF)和房水炎性因子[肿瘤坏死因子-α(TNF-α)、白细胞介素(IL)-6、IL-10],观察治疗后1个月不良反应发生情况。结果治疗后1个月患者BCVA提高,CFT、VEGF水平降低,房水TNF-α、IL-6水平也降低,差异有统计学意义(P<0.05),而IL-10、PSV、EDV无明显变化(P>0.05);治疗后1个月出现高眼压2例(2.30%),角膜水肿3例(3.45%),再出血2例(2.30%),前房炎性反应4例(4.60%),不良反应总发生率为12.64%。结论采用玻璃体腔注射雷珠单抗治疗老年PDR合并AMD效果良好。Objective To investigate the clinical effect of intravitreal injection of ranibizumab on elderly proliferative diabetic retinopathy(PDR)combined with age-related macular degeneration(AMD).Methods Eighty-seven elderly patients with PDR and AMD from October 2015 to December 2018 were treated by intravitreal injection of ranibizumab(0.5 mg)in Department of Ophthalmology,The George Washington University Hospital and Virginia Retina Center.Best corrected visual acuity(BCVA)was tested by visual acuity chart,central macular thickness(CFT)was tested by optical coherence tomography,ocular hemodynamics was tested by ultrasonograph,vascular endothelial growth factor(VEGF)and aqueous inflammatory factor[tumor necrosis factor-α(TNF-α),interleukin(IL)-6,IL-10]were detected by ELISA before and 1 month after treatment.The adverse reactions within 1 month after treatment were observed and recorded to conduct comparative analysis.Results One month after treatment,BCVA improved,CFT and VEGF decreased,the levels of TNF-αand IL-6 in the aqueous humor also decreased,the difference was statistically significant(P<0.05),while there was no changes in the levels of IL-10,PSV,EDV before and after treatment(P>0.05).During 1 month after treatment,two cases(2.30%)had ocular hypertension,3 cases(3.45%)had corneal edema,2 cases(2.30%)had rebleeding,and 4 cases(4.60%)had anterior chamber inflammation;the total incidence rate of adverse reactions was 12.64%.Conclusion Intravitreal injection of ranibizumab in the treatment of elderly PDR combined with AMD is effective.

关 键 词：雷珠单抗 糖尿病视网膜病变 黄斑变性 血流动力学 

分 类 号：R77[医药卫生—眼科]