雷珠单抗联合577nm多点扫描矩阵激光光凝治疗DME  

Clinical efficacy of Ranibizumab combined with 577nm multi-point scanning matrix laser photocoagulation in the treatment of DME patients

作　　者：梁丽银 马萍萍[1] 陈敏瑜[1] 刘清洋[1] 李达桔[1] 温秀媚[1] Li-Yin Liang;Ping-Ping Ma;Min-Yu Chen;Qing-Yang Liu;Da-Jie Li;Xiu-Mei Wen(Department of Ophthalmology, Dongguan People's Hospital, Dongguan 528300, Guangdong Province, China)

机构地区：[1]中国广东省东莞市人民医院眼科,528300

出　　处：《国际眼科杂志》2020年第6期966-969,共4页International Eye Science

基　　金：东莞市医疗卫生一般项目(No.201610515000593)。

摘　　要：目的:探讨雷珠单抗联合577nm多点扫描矩阵激光光凝治疗糖尿病性黄斑水肿(DME)患者临床疗效。方法:选取2017-01/2018-06我院收治的DME的患者94例127眼。按治疗方法的不同分为:单一组:仅通过玻璃体腔注射雷珠单抗治疗DME;联合组:玻璃体腔注射雷珠单抗联合577nm多点扫描矩阵激光治疗DME。观察两组患者完成3次雷珠单抗注射后1mo治疗效果;分别在治疗前、完成3次雷珠单抗注射后1、3、6mo检查两组患者的视力改善情况;采用光学相干断层扫描(OCT)检测两组患者黄斑中心凹厚度(CMT);使用眼底荧光血管造影(FFA)检测视网膜新生血管渗漏面积以及术后并发症情况。结果:两组患者完成3次雷珠单抗注射后1mo,联合组患者的治疗有效率(100%)高于单一组(97%)(P>0.05)。治疗前两组患者BCVA分别为0.57±0.20、0.56±0.18(P>0.05),完成3次雷珠单抗注射后1、3、6mo患者单一组BCVA分别为0.39±0.05、0.23±0.06、0.18±0.05,联合组BCVA分别为0.28±0.08、0.18±0.07、0.12±0.06,联合组患者BCVA优于对照组(P<0.001)。治疗前两组患者CMT分别为389±42.54、386±38.25μm(P>0.05),完成3次雷珠单抗注射后1、3、6mo单一组CMT分别为333.84±38.18、297.12±27.10、278.15±26.24μm,联合组CMT分别为315.04±39.07、274.35±28.63、253.65±25.91μm,联合组患者CMT改善情况优于单一组(P<0.001)。治疗前两组患者视网膜新生血管渗漏面积分别为22.31±3.26、21.98±3.18mm2(P>0.05),完成雷珠单抗注射后3、6mo,单一组渗漏面积分别为18.34±2.19、7.81±1.28mm2,联合组渗漏面积分别为14.92±1.98、5.39±1.42mm2(P<0.001)。单一组患者共3眼出现并发症,联合组患者共4眼出现并发症,两组患者并发症发生率比较无差异(P>0.05)。结论:雷珠单抗联合577nm多点扫描矩阵激光光凝对DME患者均有治疗效果且安全,联合治疗长期效果要优于单独行玻璃体腔注射雷珠单抗。·AIM:To explore the clinical effect of leizhumab combined with 577nm multi-point scanning matrix laser photocoagulation in the treatment of diabetic macular edema(DME).·METHODS:Totally 127 eyes of 94 patients(January 2017-June 2018)with DME were selected.According to the different treatment methods,RA group was divided into two groups.RA group was only treated with razumab group:the patients in this group were treated with razumab injection;RL group:razumab combined with 577nm multi-point scanning matrix laser group:the patients in this group were treated with razumab combined with 577nm multi-point scanning matrix laser photocoagulation.To observe the treatment effect of RA group and RL group 1mo after three times of leizhumab injection;to check the visual improvement of RA group and RL group before treatment and 1mo,3mo and 6mo after three times of leizhumab injection;to detect the macular fovea thickness(CMT)of RA group and RL group by optical coherence tomography(OCT);to detect the retinal neogenesis by FFA Vascular leakage area and postoperative complications.·RESULTS:The effective rate(100%)of the patients in the combined group was higher than that in the single group(97%),but the difference was not statistically significant(P>0.05).Before treatment,the BCVA of the two groups of patients were 0.57±0.20 and 0.56±0.18(P>0.05).After completing three injections of ranibizumab,the BCVA of the single group of patients at 1,3,and 6mo were 0.39±0.05,0.23±0.06,0.18±0.05,the BCVA of the combined group were 0.28±0.08,0.18±0.07,0.12±0.06,the BCVA of the combined group was better than the control group(P<0.001).Before treatment,the CMT of the two groups of patients were 389±42.54 and 386±38.25,respectively(P>0.05).After completing three injections of ranibizumab,the CMT of the single group at 1,3,and 6mo were 333.84±38.18,297.12±27.10,278.15±26.24μm,the CMT of the combined group were 315.04±39.07,274.35±28.63,253.65±25.91μm,the improvement of the CMT of the combined group was better than that of the

关 键 词：雷珠单抗 577nm多点扫描矩阵激光 临床疗效 糖尿病性黄斑水肿 

分 类 号：R73[医药卫生—肿瘤]