玻璃体注射雷珠单抗联合玻璃体切除术治疗增生性糖尿病视网膜病变患者的临床效果  

Clinical effect of vitreous injection of Ralizumab combined with vitrectomy in patients with proliferative diabetic retinopathyA

作　　者：邵嘉涛[1] 于韦韦[1] 张锦[1] SHAO Jiatao;YU Weiwei;ZHANG Jin(Department of Ultrasound,Dalian Third People's Hospital,Liaoning Province,Dalian116031,China)

机构地区：[1]辽宁省大连市第三人民医院超声科,辽宁大连116031

出　　处：《中国当代医药》2023年第5期134-140,共7页China Modern Medicine

基　　金：辽宁省大连市医学科学研究计划项目(1911026)。

摘　　要：目的探讨玻璃体注射雷珠单抗联合玻璃体切除术治疗增生性糖尿病视网膜病变患者的临床效果及对眼底血流动力学的影响。方法选取2018年1月至2019年6月来源于辽宁省大连市第三人民医院的122例(共122只患眼)增生性糖尿病视网膜病变患者作为研究对象,采用随机数字表法将其分为试验组61例(61眼)和对照组61例(61眼)。对照组患者采用单纯玻璃体切除术治疗,试验组在行玻璃体切除术前3~10 d给予玻璃体腔内注射雷珠单抗。使用彩色多普勒血流显像(CDFI)分别测量两组患者治疗前后的视网膜中央动脉参数变化,并比较术前、术后1、3、6个月等不同时间段内两组患者的各种眼科指标。结果术后1、3、6个月,试验组患者的光敏感度高于对照组,最佳矫正视力(BVCA)、黄斑中心凹视网膜厚度(CMT)、视野灰度值低于对照组,差异有统计学意义(P<0.05);术后1、3、6个月,试验组患者的视网膜中央动脉收缩期峰值流速(PSV)、舒张末期血流速度(EDV)、平均血流速度(AVP)高于对照组,搏动指数(PI)、阻力指数(RI)试验组低于对照组,差异有统计学意义(P<0.05);两组患者的并发症总发生率比较,差异无统计学意义(P>0.05)。结论对增生性糖尿病视网膜病变患者采用玻璃体注射雷珠单抗联合玻璃体切除术治疗有利于获得确切效果,促进玻璃体积血吸收、新生血管消退的同时,还能明显增强视力,积极改善患者的眼底动脉灌注。Objective To investigate the clinical effect and fundus hemodynamics of patients with proliferative diabetic retinopathy treated by vitrectomy with Ralizumab injection.Methods A total of 122 patients(122 eyes in total)with proliferative diabetic retinopathy from Dalian Third People's Hospital,Liaoning Province from January 2018 to June 2019 were selected as the study subjects,and they were divided into experimental group 61(61 eyes)and control group 61(61 eyes)by random number table.The control group was treated with vitrectomy alone,and the experimental group was given intravitreal injection of Ralizumab 3-10 days before vitrectomy.Color Doppler flow imaging(CDFI)was used to measure the changes of central retinal artery parameters before and after treatment in the two groups,and various ophthalmic indexes were compared between the two groups in different time periods,such as preoperative,postoperative 1,3 and 6 months.Results At 1,3 and 6 months after operation,the light sensitivity of the experimental group was higher than that of the control group,the best corrected visual acuity(BVCA),foveal retinal thickness(CMT),visual field gray compared with the control group,the differences were statistically significant(P<0.05).At 1,3 and 6 months after the operation,the central retinal artery systolic peak velocity(PSV),End-diastolic blood velocity(EDV)and average blood flow velocity(AVP)were higher than those in the control group,while the pulsatility index(PI)and resistance index(RI)in the experimental group were lower than those in the control group,with statistically significant differences(P<0.05).There was no significant difference in the total incidence of complications between the two groups(P>0.05).Conclusion Vitreous injection of Ralizumab combined with vitrectomy for patients with proliferative diabetic retinopathy is beneficial to obtain the exact effect,promote vitreous blood accumulation absorption and neovascularization at the same time,but also significantly enhance visual acuity and positively improve

关 键 词：玻璃体 雷珠单抗 增生性糖尿病视网膜病变 视网膜中央动脉 视力水平 眼底动脉灌注 视网膜中央动脉参数 

分 类 号：R774[医药卫生—眼科]