雷珠单抗治疗渗出型老年性黄斑变性临床效果观察  

Efficacy and prognosis of ranibizumab on exudative age-related macular degeneration patients

作　　者：黄盛梅 黄晓菁[1] Huang Shengmei;Huang Xiaojing(Department of Ophthalmology,Shanghai Pudong New Area Gongli Hospital,Shanghai 200135,China)

机构地区：[1]上海市浦东新区公利医院眼科,200135

出　　处：《山西医药杂志》2022年第6期615-618,共4页Shanxi Medical Journal

摘　　要：目的探讨雷珠单抗对渗出型老年性黄斑变性(AMD)的治疗效果,并对预后进行分析。方法选取2013年2月至2016年2月我院眼科收治的渗出型AMD患者80例,所有患者均采用玻璃体腔注射雷珠单抗治疗,1次/月,连续治疗3个月后根据患者个体情况按需治疗,观察治疗前后患者最佳矫正视力(BCVA)、黄斑中心凹视网膜厚度(CFT)、脉络膜新生血管(CNV)荧光素渗漏面积及不良反应情况。采用Spearman、Pearson分析方法对BCVA提高值与基线资料进行相关性分析。结果治疗前BCVA为(41±4)个字母数,治疗后1、2、3、6、12、18、24个月BCVA分别为(50±5)、(53±6)、(55±7)、(56±7)、(58±7)、(59±7)、(59±6)个字母数,治疗后不同时间段BCVA较治疗前均明显提高(P<0.05);治疗前CFT为(416±66)μm,治疗1、2、3、6、12、18、24个月后CFT分别为(304±49)、(287±45)、(264±40)、(250±38)、(247±38)、(233±36)、(210±31)μm,治疗后不同时间段CFT较治疗前均明显下降(P<0.05);治疗前CNV荧光素渗漏面积为(9.0±1.8)mm^(2),治疗后3、6、12、18、24个月CNV荧光素渗漏面积分别为(7.1±1.6)、(5.9±1.2)、(5.1±1.1)、(4.4±1.1)、(4.1±1.0)mm^(2),治疗后不同时间段CNV荧光素渗漏面积较治疗前均明显下降(P<0.05)。Pearson相关性分析显示,年龄、治疗前BCVA、CNV荧光素渗漏面积与BCVA提高值呈负相关性(r=-0.505、-0.592、-0.652,P均<0.05);治疗期间患者未出现严重不良反应及并发症。结论雷珠单抗治疗渗出型AMD效果显著,能够提高患者视力,降低CFT及CNV荧光素渗漏面积,安全性良好,值得临床推广应用,年龄、治疗前BCVA和CNV荧光素渗漏面积是患者长期视力预后的预测因素。Objective To investigate the treatment effect and prognosis of ranibizumab on exudative age-related macular degeneration(AMD).Methods A total of 80 patients with exudative AMD admitted to our hospital from February 2013 to February 2016 were selected,those patients were treated with ranibizumab once a month,on-demand treatment was performed after 3 months′treatment.Before and after treatment,the best corrected visual acuity(BCVA),foveal retinal thickness(CFT),choroidal neovascularization(CNV)fluorescein leakage area and adverse reactions were observed.Spearman and Pearson analysis were used to analyze the correlation between the increased value of BCVA and baseline data.Results BCVA was(41±4)letters before treatment,and were(50±5),(53±6),(55±7),(56±7),(58±7),(59±7)and(59±6)letters at 1,2,3,6,12,18 and 24 months after treatment,respectively.BCVA was significantly higher than that before treatment at different time periods(P<0.05).The CFT was(416±66)μm before treatment,and were(304±49),(287±45),(264±40),(250±38),(247±38),(233±36),(210±31)μm after treatment at 1,2,3,6,12,18,24 months,respectively.CFT was significantly reduced than that before treatment at different time periods(P<0.05).The CNV fluorescein leakage area was(9.0±1.8)mm^(2) before treatment,and were(7.1±1.6),(5.9±1.2),(5.1±1.1),(4.4±1.1)and(4.1±1.0)mm^(2) at 3,6,12,18 and 24 months after treatment,respectively.CNV fluorescein leakage area was significantly reduced than that before treatment at different time periods(P<0.05).Pearson correlation analysis showed that the age,BCVA before treatment and CNV before treatment was negatively correlated with the increased value of BCVA(r=-0.505,-0.592,-0.652,P<0.05).During treatment,there were no serious adverse reactions and complications appeared in patients.Conclusion The effect of ranibizumab treatment on exudative AMD is significant,and it can significantly improve visual acuity,reduce CFT and CNV fluorescein leakage area,which has good safety and worthy of clinical application.The

关 键 词：黄斑变性 老年人 雷珠单抗 疗效 预后 

分 类 号：R774.5[医药卫生—眼科]