IVR联合玻璃体切除术治疗PDR的疗效及对VEGF和IL-19水平的影响  

Clinical efficacy of intravitreal ranibizumab combined with vitrectomy in the treatment of proliferative diabetic retinopathy and its effect on the levels of VEGF and IL-19

作　　者：于彬科 杨维刚 吴苗 何美鸽 张瑶 胡鲁阳 冯宝平 YU Bin-ke;YANG Wei-gang;WU Miao;HE Mei-ge;ZHANG Yao;HU Lu-yang;FENG Bao-ping(Department of Ophthalmology,Xianyang Hospital of Yan'an University,Xianyang 712000,Shaanxi,CHINA)

机构地区：[1]延安大学咸阳医院眼科,陕西咸阳712000

出　　处：《海南医学》2023年第2期218-221,共4页Hainan Medical Journal

摘　　要：目的探讨雷珠单抗(IVR)联合玻璃体切除术治疗增生型糖尿病视网膜病变(PDR)的疗效及对患者血管内皮生长因子(VEGF)、白细胞介素-19(IL-19)水平的影响。方法选择2018年7月至2021年7月延安大学咸阳医院眼科收治的80例PDR患者进行研究,采用随机数表法分为对照组和观察组各40例。对照组患者给予玻璃体切除术治疗,观察组患者给予IVR联合玻璃体切除术治疗。治疗结束后比较两组患者的疗效,记录并比较治疗前和治疗结束时两组患者的黄斑中心凹、视网膜厚度、视力、VEGF、IL-19水平,并比较两组患者治疗期间的不良反应发生情况。结果观察组患者的治疗总有效率为97.50%,明显高于对照组的77.50%,差异有统计学意义(P<0.05);治疗后,两组患者的黄斑中心凹、视力均升高,且观察组患者的黄斑中心凹、视力分别为(201.41±14.41)μm、4.31±0.76,明显高于对照组的(178.98±14.89)μm、3.22±0.66,而视网膜厚度降低,且观察组患者的视网膜厚度为(237.31±14.89)μm,明显低于对照组的(287.41±15.31)μm,差异均有统计学意义(P<0.05);治疗后,两组患者的VEGF、IL-19水平均降低,且观察组患者的VEGF、IL-19分别为(48.41±8.76)pg/mL、(16.31±4.23)pg/mL,明显低于对照组的(89.41±9.12)pg/mL、(21.41±3.62)pg/mL,差异均有统计学意义(P<0.05);观察组患者的不良反应发生率为7.50%,略低于对照组的12.50%,但差异无统计学意义(P>0.05)。结论IVR联合玻璃体切除术治疗PDR可促进黄斑水肿症状减轻,改善视力,有效调节VEGF、IL-19水平,疗效显著且安全性高。Objective To investigate the clinical efficacy of intravitreal ranibizumab(IVR)combined with vitrectomy in the treatment of proliferative diabetic retinopathy(PDR)and its effect on vascular endothelial growth factor(VEGF)and interleukin-19(IL-19)level.Methods Eighty patients with PDR from Department of Ophthalmology,Xianyang Hospital of Yan'an University from July 2018 to July 2021 were selected and randomly divided into the control group and the observation group,each with 40 patients.Patients in the control group were treated with vitrectomy,while patients in the observation group were treated with IVR combined with vitrectomy.After treatment,the curative effects of the two groups were compared.The changes of macular fovea,retinal thickness,visual acuity,VEGF,and IL-19 levels were recorded before treatment and at the end of treatment.The adverse reactions of the two groups were compared.Results The total effective rate of the observation group was 97.50%,which was significantly higher than 77.50%of the control group(P<0.05).After treatment,the macular fovea and visual acuity of the two groups increased,and the macular fovea and visual acuity of the observation group were(201.41±14.41)μm and 4.31±0.76,respectively,which were significantly higher than(178.98±14.89)μm and 3.22±0.66 of the control group;the retinal thickness of the two groups decreased,and that in the observation group was(237.31±14.89)μm,significantly lower than(287.41±15.31)μm of the control group;the differences were statistically significant(P<0.05).After treatment,the levels of VEGF and IL-19 in the two groups decreased,and the levels in the observation group were(48.41±8.76)pg/mL and(16.31±4.23)pg/mL,respectively,which were significantly lower than(89.41±9.12)pg/mL and(21.41±3.62)pg/mL in the control group(P<0.05).The incidence of adverse reactions in the observation group was 7.50%,slightly lower than 12.50%in the control group(P>0.05).Conclusion IVR combined with vitrectomy for PDR can reduce macular edema symptoms,improve vis

关 键 词：增生型糖尿病视网膜病变 雷珠单抗 玻璃体切除术 血管内皮生长因子 白细胞介素-19 视网膜厚度 疗效 不良反应 

分 类 号：R587.2[医药卫生—内分泌]