雷珠单抗联合视网膜光凝治疗缺血型视网膜静脉阻塞的临床研究  

Clinical Study on Ranibizumab Combined with Reinal Photocoagulation in the Treatment of Ischemic Retinal Vein Occlusion

作　　者：邓瑾 雷晓琴[1] 艾华[1] 孙文涛[1] 柴芳[1] 刘蓓[1] DENG Jin;LEI Xiaoqin;AI Hua;SUN Wentao;CHAI Fang;LIU Bei(Department of Ophthalmology, Xi′an No.4 Hospital, Shaanxi Xi′an 710004,China)

机构地区：[1]西安市第四医院眼科,陕西西安710004

出　　处：《中国医药导刊》2020年第7期460-464,共5页Chinese Journal of Medicinal Guide

基　　金：2016年陕西省社会发展科技攻关项目(项目编号:2016SF-133,项目名称:视网膜静脉阻塞的视网膜新生血管的临床研究);西安市卫生和计划生育委员会2018年局级科研项目(项目编号J201802031,项目名称:通络驻景丸对糖尿病视网膜病变黄斑水肿作用机制研究)。

摘　　要：目的:探讨视网膜光凝术和视网膜光凝联合雷珠单抗玻璃体腔注药治疗缺血型视网膜静脉阻塞(RVO)的疗效差异。方法:选取我院缺血型RVO 60例(60眼)的临床资料进行临床对照研究。30眼视网膜中央静脉阻塞(CRVO)中,15眼行视网膜光凝术(A1组),15眼行视网膜光凝+雷珠单抗玻璃体腔注射(B1组);30眼视网膜分支静脉阻塞(BRVO)中,15眼行视网膜光凝术(A2组),15眼行视网膜光凝+雷珠单抗玻璃体腔注射(B2组)。随诊12个月以上,对比治疗前后最佳矫正视力(BCVA)改善情况和新生血管消退率。结果:CRVO组治疗后BCVA改善差异有统计学意义(P<0.05),A1和B1组术前视力差异无统计学意义(P>0.05),术后不同时间点两组之间差异均有统计学意义(P<0.05);BRVO组治疗后BCVA改善差异有统计学意义(P<0.05),A2和B2组术前视力差异无统计学意义(P>0.05),术后不同时间点差异均有统计学意义(P<0.05)。随访12个月,A组新生血管消退24眼(80%),B组新生血管消退30眼(100%),差异有统计学意义(P<0.05)。结论:对于缺血型RVO患者,雷珠单抗联合视网膜光凝组在新生血管消退率及BCVA提高上优于视网膜光凝组,雷珠单抗联合视网膜光凝组在激光治疗次数上少于视网膜光凝组。Objective:To investigate the effects of retinal photocoagulation and retinal photocoagulation combined with ranibizumab intravitreal injection on ischemic retinal vein occlusion(RVO).Methods:The clinical data of central retinal vein occlusion(CRVO)30 eyes and branch retinal vein occlusion(BRVO)30 eyes were compared.15 eyes with CRVO underwent retinal photocoagulation(group A1),and the remaining 15 eyes underwent retinal photocoagulation combined with ranibizumab intravitreal injection(group B1).15 eyes with BRVO underwent retinal photocoagulation(group A2),and the remaining 15 eyes underwent retinal photocoagulation combined with ranibizumab intravitreal injection(group B2).The regression rate of neovascularization of RVO and the improvement of BCVA before and after operation were compared and analyzed.Results:There were statistical differences(P<0.05)in BCVA before and after operation in group CRVO.There was no statistical difference(P>0.05)in preoperative BCVA between group A1 and B1,and there were statistical differences(P<0.05)in postoperative BCVA between group A1 and B1 at 1,3,6,and 12 months after operation.There were statistical significant differences(P<0.05)in BCVA before and after operation in group BRVO.There was no statistical difference(P>0.05)in preoperative BCVA between group A2 and B2,and there were statistical differences in postoperative BCVA between group A2 and B2 at 1,3,6,and 12 months after operation.There was statistical difference(P<0.05)in retinal neovascularization regression rate between group A(80%)and group B(100%).Conclusion:For ischemic RVO,the regression rate of neovascularization and BCVA improvement of retinal photocoagulation combined with ranibizumab intravitreal injection group were better than those of retinal photocoagulation group.The number of laser treatments in the ranibizumab combined retinal photocoagulation group was less than that of the retinal photocoagulation group.

关 键 词：缺血型视网膜静脉阻塞 雷珠单抗 视网膜光凝 视网膜新生血管 

分 类 号：R774.1[医药卫生—眼科]