玻璃体腔内注射雷珠单抗治疗不同类型糖尿病性黄斑水肿的效果比较  

Comparison of efficacy of intravitreal injection of ranibizumab in the treatment of different types of diabetic macular edema

作　　者：赖侦俊 李静 黄建波 LAI Zhenjun;LI Jing;HUANG Jianbo(Department of Ophthalmology,the Second Affiliated Hospital of Xiamen Medical College,Fujian Province,Xiamen 361000,China)

机构地区：[1]厦门医学院附属第二医院眼科,福建省厦门市361000

出　　处：《临床合理用药》2025年第4期36-38,43,共4页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的 比较不同类型糖尿病性黄斑水肿(DME)患者经玻璃体腔内注射雷珠单抗治疗的效果。方法 选取2022年4月—2023年4月厦门医学院附属第二医院收治的DME患者60例,根据不同类型分为非增殖型糖尿病视网膜病变(NPDR)组和增殖型糖尿病视网膜病变(PDR)组各30例,2组均给予雷珠单抗玻璃体腔内注射,6个月内接受3针治疗。比较2组术前及术后1、3、6个月的最佳矫正视力、眼压、黄斑中心凹视网膜厚度、黄斑中心凹脉络膜厚度。结果 术后3、6个月,NPDR组最佳矫正视力高于术前及同期PDR组(P<0.05或P<0.01);术后6个月,PDR组最佳矫正视力高于术前(P<0.05);各时间点2组眼压比较差异均无统计学意义(P>0.05);术后1、3、6个月,2组黄斑中心凹视网膜厚度及NPDR组黄斑中心凹脉络膜厚度均减小,且NPDR组小于PDR组(P<0.05或P<0.01);术后3、6个月,PDR组黄斑中心凹脉络膜厚度小于术前(P<0.05)。结论 雷珠单抗治疗NPDR和PDR均能改善最佳矫正视力,保持稳定眼压,并减轻黄斑水肿,但对于NPDR患者治疗效果更为显著。Objective To compare the therapeutic effect of intravitreal injection of ranibizumab in patients with different types of diabetic macular edema(DME).Methods A total of 60 DME patients admitted to the Second Affiliated Hospital of Xiamen Medical College from April 2022 to April 2023 were selected and divided into non-proliferative diabetic retinopathy(NPDR)group and proliferative diabetic retinopathy(PDR)group with 30 cases in each group according to different types.Both groups were given intravitreal injection of ranibizumab and received 3 injections within 6 months.The best corrected visual acuity,IOP,macular foveal retinal thickness and macular foveal choroidal thickness before and after surgery 1,3 and 6 months of two groups were compared.Results At 3 and 6 months after surgery,the best corrected visual acuity in NPDR group were higher than that before surgery and in PDR group at the same period(P<0.05 or P<0.01).At 6 months after surgery,the best corrected visual acuity in PDR group was higher than before surgery(P<0.05).There was no significant difference in IOP between the two groups at each time point(P>0.05).At 1,3 and 6 months after surgery,the thickness of macular foveal retina in two groups and the thickness of macular foveal choroid in NPDR group decreased,and the NPDR group were smaller than those of PDR group(P<0.05 or P<0.01).At 3 and 6 months after surgery,the thickness of macular foveal choroid in PDR group were less than those before surgery(P<0.05).Conclusion Ranibizumab treatment of both NPDR and PDR can improve best corrected visual acuity,maintain stable intraocular pressure,and reduce macular edema,but the effect is more significant in patients with NPDR.

关 键 词：糖尿病性黄斑水肿 雷珠单抗 最佳矫正视力 眼压 黄斑中心凹视网膜厚度 黄斑中心凹脉络膜厚度 

分 类 号：R587.2[医药卫生—内分泌] R774.5[医药卫生—内科学]