雷珠单抗和康柏西普玻璃体腔注射治疗特发性脉络膜新生血管的临床疗效  

Intravitreal ranibizumab therapy versus intravitreal conbercept therapy for idiopathic choroidal neovascularization acomparative study on visual acuity and central macular thickness

作　　者：李思佳 刘博儒 李思雨 解鹏亮 赵霞 白领娣 LI Sijia;LIU Boru;LI Sivu;XIE Pengliang;ZHAO Xia;BAI Lingdi(Affiliated Ophthalmology Hospital of North China University of Science and Technology/Eye Institute of Eye Hospital of Tangshan,Tangshan 063000,China)

机构地区：[1]华北理工大学附属眼科医院/河北省唐山市眼科医院,河北省唐山市063000 [2]唐山市妇幼保健院

出　　处：《中国煤炭工业医学杂志》2023年第5期531-535,共5页Chinese Journal of Coal Industry Medicine

基　　金：2022年度河北省卫生健康委员会科研计划项目(编号:20221387)。

摘　　要：目的观察雷珠单抗和康柏西普玻璃体腔注射对黄斑中心凹下型特发性脉络膜新生血管(ICNV)治疗的有效性和安全性,比较两者的治疗效果。方法对2018年9月1日—2021年10月1日于华北理工大学附属眼科医院(唐山市眼科医院)就诊的黄斑中心凹下型ICNV患者294人294眼,均接受抗血管内皮细胞生长因子(VEGF)药物玻璃体腔注射,其中雷珠单抗组182人182眼(R组),康柏西普组112人112眼(C组)。采用1+PRN(pro re nata)治疗方案。R组接受雷珠单抗0.5mg玻璃体腔注射,C组接受康柏西普0.5mg玻璃体腔注射。治疗前、治疗后第1天及每月随访均行BCVA检查、眼压检查(非接触式眼压计)、散瞳后间接眼底镜检查、OCT检查、OCTA检查,如ICNV病灶持续活动或复发重复注射药物治疗。观察比较患者治疗前、治疗后1个月和治疗后6个月BCVA、OCT检查结果。结果黄斑中心凹下型ICNV患者294人294眼,R组及C组治疗前、治疗后1个月与治疗后6个月BCVA、OCT测量黄斑中心凹厚度(CMT)平均值差异均有统计学意义(均P<0.05),同时间节点组间比较差异无统计学意义(均P>0.05)。R组治疗次数(2.4±0.8)次,C组治疗次数(2.4±0.9)次,差异无统计学意义(P>0.05)。294眼治疗随访观察过程,均未发生眼局部及全身严重并发症。结论雷珠单抗和康柏西普玻璃体腔注射能够有效控制黄斑中心凹下型ICNV病变发展,提高患者视力,减轻视网膜层间水肿,有良好的有效性和安全性,且两种药物治疗效果无明显差异。Objective The comparison of the clinical safety and efficacy of intravitreal ranibizumab and intravitreal conbercept for subfoveal idiopathic choroidal neovascularization(ICNV).Methods Two hundred and ninety-four eyes in 294patients with subfoveal idiopathic choroidal neovascularization were treated in Department of Ophthalmology of the First Hospital of China Medical University from September 2018 to October 2021.182 eyes received intravitreal ranibizumab(0.5mg/0.05ml)and 112 eyes received intravitreal conbercept(0.5mg/0.05ml).Injection was repeated if optical coherence tomography showed subretinal fluid or intraretinal edema at a four week interval.Results The Log MAR BCVA was improved significantly at the beginning of the treatment and at the 6 months of follow-up in the ranibizumab group and in the conbercept group(P<0.05).In the ranibizumab group and the conbercept group CMT decreased significantly at the final-up compared to the beginning of the treatment(P<0.05).There were no significant differences of CMT decreased between the two group at the final-up(P>0.05),as also the differences of the Log MAR BCVA(P>0.05).The average number of intravitreal injection was in(2.4±0.8)in ranibizumab group and(2.4±0.9)in conbercept group,the difference was not statistically signigicant(P>0.05).There were no systemic or ocular adverse events observed in the two group.Conclusion Intravitreal ranibizumab injection and conbercept injection are both effective and safety for the patients with ICNV.Large long-term and controlled clinical trials are also necessary to assess the safety and efficacy of this treatment modality.

关 键 词：雷珠单抗 康柏西普 特发性脉络膜新生血管 血管内皮细胞生长因子 

分 类 号：R75[医药卫生—皮肤病学与性病学]