曲安奈德联合阿柏西普治疗糖尿病性黄斑水肿的效果  

Efficacy of aflibercept combined with triamcinolone acetonide for the treatment of diabetic macular edema

作　　者：常惠 张金嵩[2] 杨倩倩[3] 刘德成[3] Chang Hui;Zhang Jinsong;Yang Qianqian;Liu Decheng(Department of Ophthalmology,Ninth People’s Hospital of Zhengzhou,Zhengzhou 450006,China;Department of Ophthalmology,The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;Department of Ophthalmology,Zhengzhou Seventh People’s Hospital,Zhengzhou 450016,China)

机构地区：[1]郑州市第九人民医院眼科,450003 [2]郑州大学第一附属医院眼科,郑州450052 [3]郑州市第七人民医院眼科,450016

出　　处：《中华眼外伤职业眼病杂志》2021年第7期552-557,共6页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的:评价阿柏西普(aflibercept)玻璃体内注射联合曲安奈德(triamicinolone acetonide)后部眼球筋膜下注射治疗糖尿病性黄斑水肿的效果。方法:回顾性分析郑州市第九人民医院2018年8月至2020年8月糖尿病性黄斑水肿60例(60眼)的临床资料。患者分为两组,每组30例(30眼),对照组行单纯阿柏西普玻璃体内注射,试验组行阿柏西普玻璃体内注射联合曲安奈德后部眼球筋膜下注射。注射后随访6个月,比较两组视力、黄斑中心区厚度及眼压。结果:两组注射后1周,1、3及6个月视力均优于注射前(P<0.05);试验组均优于对照组(t=2.289、2.829、3.022、2.826,P=0.020、0.012、0.010、0.028)。两组黄斑中心区厚度均低于正常(P<0.05);试验组均低于对照组(t=2.552、2.734、2.922、3.089,P=0.018、0.016、0.014、0.010)。试验组注射后1周平均眼压较前升高,但仍在正常范围内。结论:曲安耐德后部眼球筋膜下注射联合阿柏西普玻璃体内注射,可更有效地减轻视网膜水肿并改善视力,更加安全可靠。Objective To evaluate the efficacy of intravitreal injection of aflibercept and posterior sub-tenon’s injection of triamcinolone acetonide for diabetic macular edema.Methods The clinical data of 60 eyes of 60 patients with diabetic macular edema from Aug.2018 to Aug.2020 in the Ninth People’s Hospital of Zhengzhou were retrospectively analyzed.They were divided into two groups,with 30 eyes of 30 cases in each group.The control group received intravitreal injection of aflibercept alone,and the trial group received intravitreal injection of aflibercept combined with posterior sub-tenon’s injection of triamcinolone acetonide.After 6 months of follow-up,the visual acuity,central macular thickness and intraocular pressure between the two groups were compared.Results At 1 week,1 month,3 months and 6 months after injection,the visual acuity of the two groups were better than that before injection(P<0.05).The visual acuity of the trial group was better than that of the control group(t=2.289,2.829,3.022,2.826;P=0.020,0.012,0.010,0.028).The central macular thickness of the two groups was lower than normal(P<0.05).The central macular thickness of the trial group was lower than that of the control group(t=2.552,2.734,2.922,3.089;P=0.018,0.016,0.014,0.010).At 1 week after injection,the mean intraocular pressure in the trial group was higher than that before injection,but still in the normal range.Conclusion Posterior sub-tenon’s injection of triamcinolone acetonide combined with intravitreal injection of aflibercept can effectively reduce retinal edema and improve vision,which is safer and more reliable.

关 键 词：水肿 黄斑 糖尿病性 曲安奈德 注射 筋膜下 后部 阿柏西普 注射 玻璃体内 

分 类 号：R774.5[医药卫生—眼科] R587.2[医药卫生—临床医学]