评估糖尿病黄斑水肿抗血管内皮生长因子药物治疗预后的临床标志物研究进展  

Research progress of evaluating the prognosis of anti-vascular endothelial growth factor drug treatment for diabetic macular edema with clinical markers

作　　者：陈沁芸 张学东[1] Chen Qinyun;Zhang Xuedong(Department of Ophthalmology,The First Affiliated Hospital of Chongqing Medical University,Chongqing Key Laboratory of Ophthalmology,Chongqing Eye Institute,Chongqing 400016,China)

机构地区：[1]重庆医科大学附属第一医院眼科,重庆市眼科研究所,眼科学重庆市市级重点实验室,400016

出　　处：《中华眼底病杂志》2021年第4期321-327,共7页Chinese Journal of Ocular Fundus Diseases

摘　　要：玻璃体腔注射抗血管内皮生长因子(VEGF)药物是治疗糖尿病黄斑水肿(DME)的主要手段,但仍有30%的患者对其治疗反应差。目前能够提示抗VEGF药物治疗预后的影像标志物包括缺血指数、深层视网膜毛细血管丛的黄斑中心凹无血管区面积、微动脉瘤数量、血流密度、视网膜内层紊乱、外界膜和(或)椭圆体带破坏程度、强反射灶、视网膜内囊肿、视网膜下液;生物标志物包括超敏C反应蛋白、中性粒细胞与淋巴细胞比率、抗延胡索酸酶抗体以及眼内房水细胞间黏附分子-1、白介素(IL)-6、IL-8等。了解这些可能预测和评估抗VEGF药物治疗预后的临床标志物,可以灵活调整治疗方案,更加有效地监测、治疗、管理DME患者。Intravitreal injection of anti-vascular endothelial growth factor(VEGF)drugs is the main treatment for diabetic macular edema(DME),however,30%of patients still respond poorly to its treatment.At present,imaging markers that can indicate the prognosis of anti-VEGF drug treatment include ischemic index,deep retinal capillary plexus foveal avascular zone area,number of microaneurysms,blood flow density,disorder of the inner retinal layer,outer membrane and/or the degree of damage to the ellipsoid zone,strong reflex foci,intraretinal cysts,subretinal fluid.Biomarkers include high-sensitivity C-reactive protein,neutrophil to lymphocyte ratio,anti-fumarase antibody,intraocular aqueous humor cell adhesion molecule-1,interleukin(IL)-6,IL-8,etc.Understanding these clinical markers that may predict and evaluate the prognosis of anti-VEGF drug therapy can be beneficial to adjust the treatment plan,and more effectively monitor,treat,and manage DME patients.

关 键 词：糖尿病视网膜病变 黄斑水肿 血管生成抑制剂 生物学标记 药理学 综述 

分 类 号：R587.2[医药卫生—内分泌] R774.5[医药卫生—内科学]