融合蛋白类抗VEGF药物治疗BRVO-ME的疗效及人房水细胞因子分析  

Analysis of the Efficacy of Anti-VEGF Drugs in the Treatment for BRVO-ME and Changes of Inflammatory Factors in Human Aqueous Humor

作　　者：徐一帆[1] 王瑞峰[1] 付政[1] 唐文建[1] Yifan Xu;Ruifeng Wang;Zheng Fu;Wenjian Tang(Department of Ophthalmology,the Zhengzhou Second Hospital,Zhengzhou 450000,China)

机构地区：[1]郑州市第二人民医院眼科,郑州450000

出　　处：《中华眼视光学与视觉科学杂志》2023年第7期486-491,共6页Chinese Journal Of Optometry Ophthalmology And Visual Science

基　　金：河南省科技厅项目(222102310682)。

摘　　要：目的:对比融合蛋白类抗VEGF药物阿柏西普与康柏西普治疗继发于视网膜分支静脉阻塞(BRVO)黄斑水肿(ME)的相关临床指标及人眼房水中相关细胞因子变化。方法:前瞻性研究。随机选取2018年1月—2019年4月在郑州市第二人民医院眼科就诊的BRVO-ME患者40例(40眼),分为康柏西普组20例(20眼)和阿柏西普组20例(20眼)。采用基础注射3针+需要时再注射方式进行治疗。观察患者最佳矫正视力(BCVA),通过光学相关断层扫描(OCT)记录患者中央视网膜厚度(CRT)。每次注射前抽取患者房水,检测血管内皮生长因子(VEGF)、胎盘生长因子(PIGF)、单核细胞趋化蛋白-1(MCP-1)、白介素-6(IL-6)等指标。采用两独立样本t检验和χ^(2)检验进行数据分析。结果:与给药前相比,康柏西普组与阿柏西普组患者的BCVA与CRT在给药后均有明显改善(均P<0.05)。2组间注射次数、BCVA、CRT差异均无统计学意义(均P>0.05)。治疗后第1、2、3个月,2组患者房水中的VEGF、PIGF和IL-6均较药物注射前显著降低(均P<0.05)。2组患者房水中的MCP-1浓度在治疗第1、2个月与药物注射前相比差异无统计学意义(均P>0.05),在第3个月比给药前显著降低(P<0.05)。2组间BCVA、CRT及房水中细胞因子浓度差异无统计学意义(均P>0.05)。结论:康柏西普与阿柏西普均能提高BRVO-ME患者视力,减轻ME,且明显抑制患者房水血管生成因子和炎症因子。2种融合蛋白类抗VEGF药物治疗BRVO-ME的临床效果以及对房水细胞因子的抑制作用无明显差异。Objective:To analyze the changes of inflammatory cytokines in human aqueous humor during the medication treatment with fusion protein anti-vascular endothelial growth factor(anti-VEGF)drugs for branch retinal vein occlusion-macnlar edema(BRVO-ME).Methods:In this prospective study,Forty patients(40 eyes)with BRVO-ME who attended the Second People's Hospital of Zhengzhou from January 2018 to April 2019 were randomly selected and divided into 20 patients(20 eyes)in the Conbercepe group and 20 patients(20 eyes)in the Aflibercepe group.Three initial monthly intravitreal anti-VEGF drugs injections followed by rejection if needed was performed.The patients'best corrected visual acuity(BCVA)and centrel retinal thickness(CRT)measued by optical coherence tomography were recorded.Before each injection,a sample of the patient's aqueous humor was extracted and the indexes of VEGF,placental growth factor(PIGF),monocyte chemotactic protein-1(MCP-1),and interleukin-6(IL-6)were measured.In case of normally distributed data,a t-test was conducted to compare 2 groups,andχ^(2)test was used to compare counting data.Results:After therapy,patients'BCVA and CRT significantly improved compared to the prior injection(P<0.05).There was no significant difference in the number of injections,BCVA and CRT between the two groups(P>0.05).VEGF,PIGF,and IL-6 levels in aqueous humor were significantly lower in both groups compared to initial levels in the following treatment(P<0.05).In the first and second months of treatment,neither group of patients'MCP-1 factor concentration in aqueous humor substantially changed from baseline(P>0.05),however,in the third month of treatment,it decreased compared to baseline(P<0.05).There were no discernible differences between the two groups(P<0.05).Conclusions:Both conbercept and aflibercept can improve the visual acuity of BRVO-ME patients,reduce macular edema,and significantly inhibit the angiogenic factors and inflammatory factors of aqueous humor in patients with BRVO-ME.There was no significant difference

关 键 词：视网膜分支静脉阻塞 黄斑水肿 玻璃体腔注药 

分 类 号：R774.1[医药卫生—眼科]