1+PRN玻璃体腔雷珠单抗注射方案治疗慢性中心性浆液性脉络膜视网膜病变合并脉络膜新生血管疗效的影响因素分析  

Analysis of the Factors Influencing the Efficacy of 1+PRN Intravitreal Ranibizumab Injection Regimen in the Treatment of Chronic Central Serous Chorioretinopathy with Choroidal Neovascularization

作　　者：姚秋实 叶雷 YAO Qiu-shi;YE Lei(Department of Ophthalmology,General Hospital of Yima Coal Industry(Group)Co.,Ltd.,Yima 472300,China;Department of Ophthalmology,Zhengzhou 460 Hospital(Air Force Hospital),Zhengzhou 450000,China)

机构地区：[1]义马煤业集团股份有限公司总医院眼科,义马472300 [2]郑州460医院(空军医院)眼科,郑州450000

出　　处：《中国合理用药探索》2025年第1期84-89,共6页Chinese Journal of Rational Drug Use

基　　金：河南省医学科技攻关计划项目(LHGJ20210088)。

摘　　要：目的:探索初始阶段进行1次注射+必要时(1+PRN)玻璃体腔雷珠单抗(IVR)注射方案治疗慢性中心性浆液性脉络膜视网膜病变(CCSC)合并脉络膜新生血管(CNV)疗效的影响因素。方法:选取2021年4月~2024年4月在某院接受治疗的90例CCSC合并CNV患者。患者均接受1+PRN IVR注射方案治疗,观察患者治疗前、治疗3个月后的最佳矫正视力(BCVA,LogMAR)、视网膜下液隆起最高点高度(HPSF)、黄斑中心凹厚度(CMT)、黄斑中心凹下脉络膜厚度(SFCT),并记录其视网膜中央静脉最低血流速度(V_(min))、最大血流速度(V_(max))及CNV血流面积。根据患者治疗3月后的BCVA对患者进行分组,56例BCVA提高≥0.2LogMAR的患者纳入提高组,34例纳入未提高组,分析影响患者BCVA的因素。结果:与治疗前相比较,治疗3个月后患者的BCVA、HPSF、CMT和SFCT均降低(P<0.05),V_(min)、V_(max)和CNV血流面积均降低(P<0.05);与提高组相比较,未提高组患者的年龄较高,基线BCVA、基线HPSF、基线CMT、基线SFCT、基线CNV血流面积均升高(P<0.05),发病时间、性别、高血压和糖尿病病史、基线V_(min)、基线V_(max)比较均无统计学差异(P>0.05)。经多因素分析可知,年龄、基线BCVA、基线CMT、基线CNV血流面积均对治疗后BCVA存在影响。结论:1+PRN IVR注射方案对CCSC合并CNV的患者具有显著疗效,年龄、基线BCVA、基线CMT和基线CNV血流面积均会影响患者的治疗效果。Objective:To investigate the factors influencing the efficacy of 1+PRN intravitreal ranibizumab(IVR)injection regimen in the treatment of chronic central serous chorioretinopathy(CCSC)with choroidal neovascularization(CNV).Methods:A total of 90 patients with CCSC and CNV treated in a hospital from April 2021 to April 2024 were selected.All patients were treated with the 1+PRN IVR injection regimen.The best corrected visual acuity(BCVA,LogMAR),height of the peak of subretinal fluid(HPSF),central macular thickness(CMT)and subfoveal choroidal thickness(SFCT)were observed before treatment and after 3 months of treatment.Additionally,the minimum blood flow velocity(V_(min))and maximum blood flow velocity(V_(max))of the central retinal vein,and CNV blood flow area were recorded.Based on the BCVA of patients after 3 months of treatment,56 patients with a BCVA improvement of≥0.2LogMAR were included in the improvement group,while the other 34 patients were included in the non-improvement group to explore the factors influencing the BCVA of patients.Results:Compared to values before treatment,the BCVA,HPSF,CMT and SFCT were decreased(P<0.05),and V_(min),V_(max) and CNV blood flow area were decreased(P<0.05)in patients after 3 months of treatment.Compared with the improvement group,the patients in the non-improvement group had higher age,with higher baseline BCVA,baseline HPSF,baseline CMT,baseline SFCT and baseline CNV flow area(P<0.05).There was no statistically significant difference in onset time,gender,history of hypertension and diabetes,baseline V_(min) and baseline V_(max) between the two groups(P>0.05).Multivariate analysis showed that age,baseline BCVA,baseline CMT and baseline CNV blood flow area all affected the BCVA of patients after treatment.Conclusion:The 1+PRN IVR injection regimen has significant efficacy in patients with CCSC and CNV.Age,baseline BCVA,baseline CMT,and baseline CNV blood flow area all influence the treatment outcomes of patients.

关 键 词：1+PRN方案 雷珠单抗 慢性中心性浆液性脉络膜视网膜病变 脉络膜新生血管 影响因素 

分 类 号：R774.5[医药卫生—眼科]