雷珠单抗不同重复注药标准治疗视网膜分支静脉阻塞继发黄斑水肿的效果比较  

Comparison of Efficacy of Different Criteria for Repeated Drug Injections of Ranibizumab in the Treatment of Macular Edema Secondary to Retinal Branch Vein Occlusion

作　　者：文美丹 何小娟 罗海燕[1] 郝晓辉 杨帆[1] WEN Meidan;HE Xiaojuan;LUO Haiyan;HAO Xiaohui;YANG Fan(Nanxishan Hospital of Guangxi Zhuang Autonomous Region,Guilin 541002,China;不详)

机构地区：[1]广西壮族自治区南溪山医院,广西桂林541002

出　　处：《中外医学研究》2024年第4期38-41,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

基　　金：广西壮族自治区卫生健康委员会自筹科研课题项目(Z20201408,Z20190734);广西壮族自治区南溪山医院院级科研课题项目(NY202003)。

摘　　要：目的:探讨雷珠单抗不同重复注药标准治疗视网膜分支静脉阻塞继发黄斑水肿的效果。方法:选择2020年7月—2022年7月在广西壮族自治区南溪山医院眼科确诊为视网膜分支静脉阻塞继发黄斑水肿的60例(60眼)的患者为研究对象,患者均采用玻璃体腔注射雷珠单抗治疗。采用前瞻性随机对照研究方法,将患者按随机数表法分入试验组(n=30)和对照组(n=30)。试验组重复注药标准为黄斑中心凹厚度(central macular thickness,CMT)>250μm或存在中心凹或中心凹旁水肿(严格的注药标准)。对照组重复注药标准为CMT>300μm,较末次随访明显增厚,且视力下降大于1行(宽松的注药标准)。两组均随访半年,每月随访1次。观察两组患者随访期间的平均注射次数、治疗前后最佳矫正视力(best corrected visual acuity,BCVA)、CMT及并发症发生情况。结果:试验组患者的平均注射次数显著多于对照组,差异有统计学意义(P<0.05)。两组患者治疗前最佳矫正视力比较,差异无统计学意义(P>0.05);与治疗前相比,试验组患者治疗不同时间的BCVA均显著升高,对照组患者治疗4个月、5个月、6个月的BCVA显著升高,差异有统计学意义(P<0.05);试验组患者治疗2个月、3个月、4个月、5个月、6个月的BCVA均显著高于对照组,差异有统计学意义(P<0.05)。治疗前,两组患者CMT比较,差异无统计学意义(P>0.05);与治疗前相比,两组患者治疗不同治疗时间的CMT均显著降低,且试验组患者CMT显著低于对照组,差异有统计学意义(P<0.05)。研究期间两组均未发生雷珠单抗注射相关的眼部或非眼部并发症。结论:宽松的雷珠单抗重复注药标准可使随访期间的重复注药次数显著减少,严格的重复注药标准更有助于BCVA及CMT的改善,在临床中,应根据患者的具体情况进行选择。Objective:To investigate the efficacy of different criteria for repeated drug injections of Ranibizumab in the treatment of macular edema secondary to retinal branch vein occlusion.Method:A total of 60 patients(60 eyes)diagnosed with macular edema secondary to retinal branch vein occlusion were selected from July 2020 to July 2022 in the Ophthalmology Department of Nanxishan Hospital of Guangxi Zhuang Autonomous Region.All patients were treated with intravitreal injection of Ranibizumab.A prospective randomized controlled study was conducted,and patients were randomly divided into experimental group(n=30)and control group(n=30)according to the random number method.In the experimental group,the repeated drug injections was the central macular thickness(CMT)>250μm or the presence of foveal or parafoveal edema(strict criteria for repeated drug injections).In the control group,the repeated drug injections was CMT>300μm,which was significantly thicker than the last follow-up,and the visual acuity decreased by more than 1 line(looser criteria for repeated drug injections).Both groups were followed up for six months,once a month.The average number of injections,best corrected visual acuity(BCVA),CMT before and after treatment and the incidence of complications were observed.Result:The average injection frequency of the experimental group was significantly higher than that of the control group,the difference was statistically significant(P<0.05).There was no significant difference in value of BCVA between the two groups before treatment(P>0.05).Compared with BCVA of before treatment,the values of BCVA of the experimental group were significantly increased at different treatment times,while the values of BCVA of the control group were significantly increased at 4 months,5 months and 6 months,the differences were statistically significant(P<0.05).The values of BCVA of the experimental group at 2 months,3 months,4 months,5 months and 6 months after treatment were significantly higher than those of the control group,the di

关 键 词：雷珠单抗 重复注药标准 视网膜分支静脉阻塞 黄斑水肿 

分 类 号：R774.5[医药卫生—眼科]