复方血栓通辅助贝伐单抗治疗对湿性老年黄斑变性主要和次要结局的作用  

Effect of Compound Xueshuantong Combined with Bevacizumab on Primary and Secondary Outcomes of Wet Age-related Macular Degeneration

作　　者：任刚[1] 甘国菊[1] REN Gang;GAN Guoju(Department of Ophthalmology,Dazhou Hospital of Integrated Traditional Chinese and Western Medicine,Dazhou,Sichuan 635000,China)

机构地区：[1]达州市中西医结合医院眼科,四川达州635000

出　　处：《临床误诊误治》2024年第13期95-100,共6页Clinical Misdiagnosis & Mistherapy

基　　金：达州市科技计划项目(21CYRC0002)。

摘　　要：目的探讨复方血栓通辅助贝伐单抗治疗湿性老年黄斑变性(wAMD)的临床效果。方法选取2021年4月至2023年5月收治的62例wAMD患者,随机数字表法分为2组,各31例。单抗组予以贝伐单抗治疗,联合组予以复方血栓通联合贝伐单抗治疗,2组均治疗3个月。比较2组临床疗效、最佳矫正视力(BCVA)最小分辨角对数(LogMAR)、黄斑中心凹视网膜厚度(CRT)、眼血流动力学[收缩期峰值流速(PSV)、舒张末期流速(EDV)、阻力指数(RI)]、血清因子[血管内皮生长因子(VEGF)、白细胞介素-1(IL-1)、IL-6、IL-17、血管内皮细胞生长抑制因子(VEGI)、肿瘤坏死因子-α(TNF-α)]及不良反应。结果联合组总有效率为93.55%(29/31)高于单抗组70.97%(22/31)(P<0.05)。联合组治疗1、3个月后BCVA(LogMAR)优于单抗组,CRT低于单抗组(P<0.05);联合组治疗1、3个月后RI、IL-6、TNF-α、IL-1、IL-17、VEGF低于单抗组,PSV、EDV、VEGI高于单抗组(P<0.05)。联合组贝伐单抗的注射次数少于单抗组(P<0.01)。2组不良反应发生率比较无显著差异(P>0.05)。结论复方血栓通辅助贝伐单抗治疗wAMD可有效调控血管生成因子水平,抑制促炎因子,改善眼血流动力学,减少贝伐单抗注射次数,从而改善局部病变,且治疗安全性高。Objective To explore the clinical effect of compound Xueshuantong and Bevacizumab in the treatment of wet age-related macular degeneration(wAMD).Methods A total of 62 wAMD patients admitted from April 2021 to May 2023 were randomly divided into two groups,with 31 patients in each group.The Bevacizumab group was treated with Bevacizumab,and the combined group was treated with compound Xueshuantong combined with Bevacizumab.Both groups were treated for 3 months.The clinical efficacy,best corrected visual acuity(BCVA)logarithm of the minimum angle of resolution(LogMAR),foveal retinal thickness(CRT),ocular hemodynamics[peak systolic velocity(PSV),end-diastolic velocity(EDV),resistance index(RI)],serum factors[vascular endothelial growth factor(VEGF),interleukin-1(IL-1),interleukin-6(IL-6),interleukin-17(IL-17),vascular endothelial growth inhibitor(VEGI),tumor necrosis factor-α(TNF-α)]and adverse reactions were compared between the two groups.Results The total effective rate of combination group was 93.55%(29/31),which was higher than that of Bevacizumab group[70.97%(22/31)](P<0.05).At 1 and 3 months after treatment,BCVA(LogMAR)in combination group was better than that in Bevacizumab group,and CRT was lower than that in Bevacizumab group(P<0.05).At 1 and 3 months after treatment,RI,IL-6,TNF-α,IL-1,IL-17 and VEGF in combination group were lower than those in Bevacizumab group,while PSV,EDV and VEGI were higher than those in Bevacizumab group(P<0.05).The injection times of Bevacizumab in combination group was less than that in Bevacizumab group(P<0.01).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion In the treatment of wAMD,compound Xuesuantong and Bevacizumab can effectively regulate the level of angiogenic factors,inhibit pro-inflammatory factors,improve ocular hemodynamics,reduce the number of Bevacizumab injections,and thus alleviate local lesions,and the treatment is safe.

关 键 词：湿性黄斑变性 老年人 复方血栓通 贝伐单抗 最佳矫正视力 血流动力学 血管内皮生长因子 白细胞介素-1 

分 类 号：R774.5[医药卫生—眼科]