抗VEGF药物联合引流器植入术治疗新生血管性青光眼的效果  

Efficacy of the intravitreal injection of anti-VEGF drugs combined with drainage device implantation in the treatment of neovascular glaucoma

作　　者：韩智 李维欣[2] 岳晓红[1] 王沛[1] 董敬民[2] Han Zhi;Li Weixin;Yue Xiaohong;Wang Pei;Dong Jingmin(Department of Blood Purification Center,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;Department of Ophthalmology,the First Affiliated Hospital of Zhengzhou University,Henan Provinivial Ophthalmic Hospital,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院血液净化中心,郑州450052 [2]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10期781-786,共6页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的评价玻璃体内注射抗VEGF药物联合EX-PRESS引流器植入术治疗新生血管性青光眼(NVG)的临床效果。方法前瞻性随机对照研究。纳入2020年1月至2021年10月就诊于郑州大学第一附属医院眼科的NVG 92例(92眼), 采用随机数字表法分为对照组和试验组, 每组各46例(46眼), 两组均行玻璃体内注射抗VEGF药物(康柏西普)进行常规治疗, 在此基础上对照组行小梁切除术, 试验组行EX-PRESS引流器植入术。随访3个月, 比较两组术后成功率、视力、眼压及房水相关因子水平。结果术后3个月试验组手术相对成功率36.00%(9/25)高于对照组的12.00%(3/25)(χ2=3.95, P=0.047);试验组的视力提高率44.00%(11/25)高于对照组的16.00%(4/25)(χ2=4.67, P=0.031)。术后5 d两组房水中血管内皮生长因子(VEGF)、IL-6及IL-8水平降低, 且试验组低于对照组(均P<0.05)。结论 NVG采用玻璃体内注射抗VEGF药物及EX-PRESS引流器植入术治疗可更好地提升手术相对成功率、改善视力, 并可减轻机体炎症反应。Objective To investigate the clinical efficacy of intravitreal injection of anti-VEGF drugs combined with drainage device implantation in the treatment of neovascular glaucoma(NVG).Methods This was a prospective random control study.A total of 92 eyes of 92 NVG patients who were treated in the First Affiliated Hospital of Zhengzhou University from Jan.2020 to Oct.2021 were included.They were divided into the control group and the tiral group based on random number table method,with 46(46 eyes)of cases in each group.Both groups were given intravitreal injection of anti-VEGF drug(conbercept)for routine treatment.On this basis,the control group received trabeculectomy,and the tiral group received EX-PRESS drainage device implantation.The follow-up time was 3 months.The postoperative success rate,postoperative visual acuity,intraocular pressure,and the levels of aqueous humor-related factors were compared between the two groups.Results At 3 months after operation,the relative success rate of surgery in the tiral group was 36.00%(9/25),which was higher than the 12.00%(3/25)in the control group(χ2=3.95,P=0.047).The visual acuity improvement rate of the tiral group was 44.00%(11/25),which was higher than the 16.00%(4/25)of the control group(χ2=4.67,P=0.031).The levels of VEGF,IL-6 and IL-8 in the aqueous humor of the two groups decreased at 5 days after the operation,and the tiral group was lower than the control group(all P<0.05).Conclusion Intravitreal injection of anti-VEGF drugs combined with EX-PRESS drainage device implantation for NVG patients can better improve the relative success rate of surgery,improve visual acuity,and reduce the body's inflammatory response.

关 键 词：青光眼 新生血管性 康柏西普 引流器植入术 血管内皮生长因子 房水中 白细胞介素-6 白细胞介素-8 

分 类 号：R775[医药卫生—眼科]