雷珠单抗康柏西普玻璃体注射联合AGV治疗新生血管性青光眼的效果及对房水VEGF IL-6水平的影响  

Effects of Intravitreal Injection of Ranibizumab or Conbercept Combined with AGV on Neovascular Glaucoma and Their Influence on VEGF and IL-6 Levels in Aqueous Humor

作　　者：王茜 赵晓霞 吴娟 李海青 秦小萍 WANG Qian;ZHAO Xiaoxia;WU Juan(Xining First People's Hospital, Qinghai Xining 810000, China)

机构地区：[1]青海省西宁市第一人民医院眼科,青海西宁810000

出　　处：《河北医学》2021年第5期789-794,共6页Hebei Medicine

基　　金：青海省基础研究计划项目,(编号:2021-0301-ZJC-0037)。

摘　　要：目的:探讨雷珠单抗、康柏西普玻璃体注射联合Ahemd青光眼引流阀(AGV)治疗新生血管性青光眼(NVG)的效果及对房水血管内皮生长因子(VEGF)、白细胞介素-6(IL-6)水平的影响。方法:选取2017年12月至2019年12月我院收治的NVG患者96例(96眼),对所有患者临床资料进行回顾性分析。根据治疗方案不同将患者分为雷珠单抗组(A组,34例34眼)、康柏西普组(B组,33例33眼)和对照组(C组,29例29眼)。观察患者虹膜和房角表面新生血管消退情况,比较三组患者手术前后眼压、视力及房水VEGF、IL-6水平,记录术后并发症发生率。结果:A、B两组患者虹膜和房角表面新生血管消退情况良好,C组患者仍存在新生血管,三组间差异显著(P<0.05),A、B组比较差异无统计学意义(P>0.05);术前和术后2周、1个月、3个月、6个月,三组眼压的组间、时间点、组间×时间点比较差异有统计学意义(P<0.05),三组患者术后2周、1个月、3个月、6个月的眼压均较术前明显降低(P<0.05),A组、B组术后6个月视力改善情况好于C组(P<0.05),但A、B两组间上述指标比较差异无统计学意义(P>0.05);三组术后6个月视力情况对比,差异无统计学意义(P>0.05);治疗后,三组房水VEGF、IL-6水平均较治疗前降低(P<0.05),且三组上述指标治疗前后差值对比,差异有统计学意义(P<0.05);三组患者并发症发生率比较差异无统计学意义(P>0.05)。结论:玻璃体注射雷珠单抗或康柏西普联合AGV治疗NVG疗效及安全性可靠,可有效降低眼压、改善视力,促进新生血管消退,抑制房水中血管活性物质和炎性因子表达,且两种药物的治疗效果相当。Objective:To explore the effects of intravitreal injection of ranibizumab or conbercept combined with ahemd glaucoma valve(AGV)in the treatment of neovascular glaucoma(NVG)and their influence on vascular endothelial growth factor(VEGF)and interleukin-6(IL-6)levels in aqueous humor.Methods:A total of 96 patients(96 eyes)with NVG admitted to our hospital from January 2016 to May 2018 were selected,and the clinical data of all patients were retrospectively analyzed.Patients were divided into ranibizumab group(group A,34 cases,34 eyes),conbercept group(group B,33 cases,33 eyes)and control group(group C,29 cases,29 eyes)according to different treatment regimens.The neovascularization regression of iris and chamber angle surface was observed among patients.The intraocular pressure,visual acuity and aqueous humor VEGF and IL-6 levels in the three groups were compared before and after surgery.The incidence rate of postoperative complications was recorded.Results:The neovascularization regression of iris and chamber angle surface was good in groups A and B,and there were still new blood vessels in group C,and the difference among the three groups was significant(P<0.05),and there was no statistical difference between group A and group B(P>0.05).There were statistical significance in the between-group effect,time-point effect and interaction of time-point and between-group of intraocular pressure among the three groups before surgery and at 2 w,1 month,3 months and 6 months after surgery(P<0.05).The intraocular pressure in the three groups at 2 w,1 month,3 months and 6 months after surgery was significantly decreased compared with that before surgery,and the improvement of visual acuity in group A and group B was better than that in group C at 6 months after surgery(P<0.05),but there were no significant differences in the above indexes between group A and group B(P>0.05).There was no significant difference in visual acuity among the three groups at 6 months after surgery(P<0.05).After treatment,the levels of VEGF and IL-6

关 键 词：雷珠单抗 康柏西普 Ahemd青光眼引流阀 新生血管性青光眼 

分 类 号：R73[医药卫生—肿瘤]