抗VEGF药物联合Ahmed引流阀植入术治疗新生血管性青光眼患者的效果及其对眼动脉血流动力学、血清VEGF及PDGF水平的影响  

Effect of anti-VEGF drugs combined with Ahmed drainage valve implantation in the treatment of neovascular glaucoma and its influence on ocular arterial hemodynamics,serum VEGF and PDGF levels

作　　者：任远 杨颖 王凤仙 REN Yuan;YANG Ying;WANG Fengxian(Department of Ophthalmology,The Third People's Hospital of Zhengzhou City,Zhengzhou,450000,China)

机构地区：[1]郑州市第三人民医院眼科,河南郑州450000

出　　处：《实用防盲技术》2024年第4期144-147,共4页Journal of Practical Preventing Blind

摘　　要：目的 探讨Ahmed青光眼阀植入术联合抗血管内皮生长因子(VEGF)药物治疗新生血管性青光眼的效果。方法 掷币法我科62例(95眼)新生血管性青光眼患者分2组,对照组31例(47眼)行Ahmed青光眼阀植入术,观察组31例(48眼),术前1w在眼内注射0.5mg雷珠单抗,随访6个月,对比两组新生血管消退情况、眼动脉血流动力学、血清血小板衍生生长因子(PDGF)及VEGF、成功率和并发症。结果 3个月末,观察组新生血管消退率95.83%、6个月末手术总成功率95.83%高于对照组的76.60%和78.72%(χ^(2)=7.441,6.299,P<0.05),舒张末期流速(EDV)(10.92±0.51) cm/s、收缩期峰值流速(PSV)(35.07±3.66) cm/s高于对照组的(7.41±0.45) cm/s、(29.34±3.07) cm/s(t=35.542,8.259,P<0.05),3个月末眼动脉血流阻力系数(RI)(0.70±0.08)、眼压(14.24±3.36) mmHg、PDGF (83.25±18.44) ng/L及VEGF (328.31±41.62) ng/L低于对照组(0.76±0.07)、(21.12±4.67) mmHg、(147.41±26.55) ng/L及(531.83±58.46) ng/L (t=3.887,8.228,13.654,19.511,P<0.05),两组并发症无统计学差异(P>0.05)。结论 新生血管性青光眼患者Ahmed青光眼阀植入术前1w联合雷珠单抗治疗,可有效改善患者眼动脉血流动力学和VEGF、PDGF水平,促进新生血管消退,提高手术成功率且较安全。Objective To investigate the effect of Ahmed glaucoma valve implantation combined with anti-vascular endothelial growth factor(VEGF)in the treatment of neovascular glaucoma.Methods Total of 62 patients(95 eyes)with neovascular glaucoma in our department were selected.According to the toss method,they were divided into 2 groups,31 patients(47eyes)in the control group were treated with Ahmed glaucoma valve implantation,and 31 patients(48 eyes)in the observation group were injected with 0.5 mg ranibizumab 1w before surgery,followed up for 6 months.Neovascularization,ocular arterial hemodynamics,serum platelet-derived growth factor(PDGF)and VEGF,success rate and complications were compared between the two groups.Results The regression rate of neovascularization after 3 months(95.83%)and the total success rate after 6 months(95.83%)in the observation group were higher than those in the control group(76.60%and 78.72%)(χ^(2)=7.441,6.299,P<0.05).End-diastolic velocity(EDV)(10.92±0.51)cm/s,peak systolic velocity(PSV)(35.07±3.66)cm/s were higher than those in control group(7.41±0.45)cm/s and(29.34±3.07)cm/s(t=35.542,8.259,P<0.05),At the end of 3 months,the blood flow esistance index(RI),IOP(14.24±3.36)mmHg,PDGF(83.25±18.44)ng/L and VEGF(328.31±41.62)ng/L were lower than those in control group(0.76±0.07),(21.12±4.67)mmHg,(147.41±26.55)ng/L and(531.83±58.46)ng/L(t=3.887,8.228,13.654,19.511,P<0.05),there was no significant difference in complications betweenthe the two groups(P>0.05).Conclusion In patients with neovascular glaucoma treated with Ahmed glaucoma valve implantation 1w before combined with ranibizumab can effectively improve the ocular arterial hemodynamics and the levels of VEGF and PDGF of the patients,and promote the regression rate of neovascularization,improve the success rate of surgery and be safe.

关 键 词：新生血管性青光眼 AHMED青光眼阀植入术 抗血管内皮生长因子药物 眼动脉血流动力学 

分 类 号：R779.6[医药卫生—眼科]