玻璃体切除术联合康柏西普玻璃体腔注射治疗糖尿病性视网膜病变  

Efficacy of vitrectomy combined with intravitreal conbercept injection for the treatment of proliferative diabetic retinopathy

作　　者：赵睿[1] 梁申芝[1] 万光明[1] Zhao Rui;Liang Shenzhi;Wan Guangming(Department of Ophthalmology,The First Affiliated Hospital of Zhengzhou University,Henan Provincial Ophthalmic Hospital,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院眼科,河南省眼科医院,郑州450052

出　　处：《中华眼外伤职业眼病杂志》2022年第6期442-446,共5页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的评价玻璃体切除术联合康柏西普玻璃体腔注射治疗增生性糖尿病性视网膜病变(PDR)患者的效果。方法采用前瞻性随机对照研究。纳入2019年1月至2021年1月郑州大学第一附属医院PDR者134例(134眼)。所有患者均行玻璃体切除术。按随机数字表法分为A、B两组,每组67例(67眼),A组术毕玻璃体腔注射康柏西普与曲安奈德,B组玻切术毕玻璃体腔注射曲安奈德。术后随访3个月,对比分析术后视力(BCVA)、黄斑中心区厚度(CMT)及再次出血等并发症的发生率。结果术后两组视力均较术前提高(F=653.53,P<0.001),术后1个月及2个月,A组视力(BCVA,LogMAR)为0.79±0.29及0.69±0.23,优于B组的0.92±0.31及0.80±0.33(t=0.69、6.03,P=0.011、0.033),术后3个月两组视力差异无统计学意义(t=4.57,P=0.284)。术后1个月及2个月A组CMT为(290.91±78.52)μm及(263.25±58.87)μm,均低于B组的(321.74±83.92)μm及(288.88±80.97)μm(t=4.33、9.72,P=0.030、0.038)。术后3个月两组CMT差异无统计学意义(t=21.03,P=0.649)。术后3个月内,A组未观察到玻璃体积血,B组观察到3例玻璃体积血。结论玻璃体切除康柏西普玻璃体腔注射,可以较快提高视力,降低CMT,并无再次出血等并发症。Objective To evaluate the efficacy of intravitreal conbercept injection during vitrectomy for the treatment of proliferative diabetic retinopathy(PDR).Methods This was a prospective randomized controlled study.Total of 134 eyes of 134 patients who received vitrectomy from Jan.2019 to Jan.2021 in the First Affiliated Hospital of Zhengzhou University were included.Patients were divided into two groups based on random number table methods,67 eyes of 67 patients in each group.Group A received intravitreal injection of conbercept and triamcinolone acetonide during vitrectomy,and group B received intravitreal injection of triamcinolone acetonide during vitrectomy.The postoperative best corrected visual acuity(BCVA),central macular thickness(CMT)and the incidence of postoperative complications such as postoperative hemorrhage were analyzed at 3 months after surgery.Results BCVA of both group increased after surgery compared with that before surgery(F=653.53,P<0.001).At 1 and 2 months after surgery,the BCVA of group A was 0.79±0.29 and 0.69±0.23,which was better than 0.92±0.31 and 0.80±0.33 of the group B(t=0.69,6.03;P=0.011,0.033),and there was no statistical significance in the BCVA between the two groups at 3 months after surgery(t=4.57,P=0.284).At 1 and 2 months after surgery,CMT of group A was(290.91±78.52)μm and(263.25±58.87)μm,which was lower than(321.74±83.92)μm and(288.88±80.97)μm of group B.(t=4.326,9.723;P=0.030,0.038).There was no significant difference in CMT between the two groups at 3 months after surgery(t=21.03,P=0.649).During the 3 months of follow-up,postoperative vitreous hemorrhage did not occur in group A,while 3 cases occurred in group B.Conclusion The application of conbercept intravitreal injection during vitrectomy can quickly improve the postoperative BCVA,decrease the CMT,and there is no incidence of postoperative hemorrhage.

关 键 词：视网膜病变 糖尿病性 增生性 康柏西普 积血 玻璃体 玻璃体切除术 厚度 中心区 黄斑 

分 类 号：R587.2[医药卫生—内分泌] R774.1[医药卫生—内科学]