玻璃体切割术前注射雷珠单抗对增殖性糖尿病视网膜病变患者的治疗效果  

Efficacy of leizumab injection before vitrectomy in patients with proliferative diabetic retinopathy

作　　者：彭俊 PENG Jun(People's Hospital of Gushi County,Gushi,465200,China)

机构地区：[1]固始县人民医院,河南固始465200

出　　处：《实用防盲技术》2024年第4期161-164,160,共5页Journal of Practical Preventing Blind

摘　　要：目的 于玻璃体切割术(PPV)术前采取玻璃体腔注入雷珠单抗,对增殖性糖尿病视网膜病变(PDR)伴玻璃体积血患者的治疗效果。方法 蓝白球法将2023年2月-2024年2月我科诊治的40例(65只眼)PDR伴玻璃体积血患者分对照组(n=20,33只眼、PPV)、研究组(n=20,32只眼、PPV及术前注射雷珠单抗),对比疗效、眼压、黄斑中心视网膜厚度(CMT)、最佳矫正视力(BCVA)、基质细胞衍生因子-1 (SDF-1)、血管内皮生长因子(VEGF)等。结果 (1)研究组治疗总有效率(95.00%)比对照组(70.00%)高,χ^(2)=4.329,P=0.037;研究组并发症发生率是10.00%,低于对照组的40.00%,χ^(2)=4.800,P=0.028。(2)治疗后研究组CMT (232.18±34.65) um、BCVA (0.327±0.017)、眼压(17.88±1.18) mmHg、SDF-1 (466.28±52.19) mg/L、VEGF (132.25±22.37) pg/ml,均依次优于对照组的(25 8.78±40.60) um、(0.270±0.0 1 5)、(23.56±1.22) mmHg、(572.31±62.13) mg/L、(178.67±28.58) pg/ml,P均<0.05。结论 PPV术前雷珠单抗注入玻璃体腔内,对PDR伴玻璃体积血患者的疗效显著、并发症少,还能有效改善眼压、视力等眼部指标、降低血清SDF-1、VEGF水平,该疗法具有较高的应用及推广价值。Objective To investigate the therapeutic effect of intravitreal injection of razumab on proliferative diabetes retinopath(PDR)with vitreous hemorrhage before vitrectomy(PPV).Methods Forty patients(65 eyes)with PDR and vitreous hemorrhage treated in our department from February 2023 to February 2024 were divided into a control group(n=20,33 eyes,PPV)and a study group(n=20,32 eyes,PPV and preoperative injection of ranibizumab)using the blue white sphere method.The efficacy,intraocular pressure,macular central retinal membrane thickness(CMT),best corrected visual acuity(BCVA),stromal cell-derived factor-1(SDF-1),vascular endothelial growth factor(VEGF),etc.were compared.Results(1)The total effective rate of the study group(95.00%)was higher than that of the control group(70.00%),χ^(2)=4.329,P=0.037;The complication rate of the study group was10.00%,which was lower than that of the control group 40.00%,χ^(2)=4.800,P=0.028.(2)After treatment,the study group had CMT(232.18±34.65)um,BCVA(0.327±0.017),IOP(17.88±1.18)mmHg,SDF-1(466.28±52.19)mg/L,VEGF(132.25±22.37)pg/ml,They were successively superior to(258.78±40.60)um,(0.270±0.015),(23.56±1.22)mmHg,(572.31±62.13)mg/L,(178.67±28.58)pg/ml in the control group,all P<0.05.Conclusion Preoperative injection of ranibizumab into the vitreous cavity of patients with PDR accompanied by vitreous hemorrhage has significant therapeutic effects and few complications.It can also effectively improve eye indicators such as intraocular pressure and vision,and reduce serum SDF-1 and VEGF levels.This therapy has high application and promotion value.

关 键 词：PDR 玻璃体积血 PPV 雷珠单抗 视力 眼压 SDF-1、VEGF 

分 类 号：R779.6[医药卫生—眼科] R587.2[医药卫生—临床医学]