PDR患者玻璃体切除术中应用抗VEGF药物预防术后玻璃体积血的临床观察  

Clinical observation of intravitral anti-VEGF drugs in the prevention of vitreous hemorrhage during vitrectomy for proliferative diabetic retinopathy

作　　者：范志华[1] 高雪霞[1] 孔晓路[1] 田野[1] 李铮[1] Fan Zhihua;Gao Xuexia;Kong Xiaolu;Tian Ye;Li Zheng(Department of Ophthalmology,Zhengzhou Municipal Second People′s Hospital,Zhengzhou 450006,China)

机构地区：[1]郑州市第二人民医院眼科,郑州450006

出　　处：《中华眼外伤职业眼病杂志》2024年第11期843-848,共6页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的观察增生型糖尿病视网膜病变(PDR)患者玻璃体切除术(PPV)中玻璃体腔注射抗血管内皮生长因子(VEGF)药物预防术后玻璃体积血(VH)的疗效。方法回顾性病例对照研究。纳入郑州市第二人民医院2023年1月至2023年11月行PPV治疗的PDR 60例(60眼),根据治疗方法分为两组:注射组30例(30眼),PPV术中玻璃体腔注入雷珠单抗,对照组30例(30眼)术中未注入雷珠单抗。观察两组术前及术后最佳矫正视力(BCVA,logMAR)、VH、黄斑中心区厚度(CMT)。结果两组术前年龄、性别、眼压、BCVA、视网膜激光情况、视网膜前增生膜等差异均无统计学意义(均P>0.05)。术前、术后1周、1、3及6个月注射组BCVA依次为1.59±0.47、1.06±0.56、0.72±0.59、0.62±0.80、0.45±0.76;对照组BCVA依次为1.43±0.51、1.07±0.48、0.68±0.32、0.64±0.56、0.48±0.56,两组间各时间点视力两两比较差异无统计学意义(均P>0.05)。术后1个月,注射组1眼发生VH,对照组4眼发生VH;术后3及6个月,注射组各有1眼发生VH,与对照组相比较,差异均无统计学意义(均P>0.05)。术后1周、1、3及6个月注射组CMT依次为(349.97±19.75)、(275.07±25.45)、(264.81±69.76)、(254.54±54.56)μm,对照组CMT依次为(347.30±24.55)、(325.83±20.75)、(365.45±89.86)、(325.24±96.35)μm,两组间比较术后1周差异无统计学意义(P>0.05),术后1、3及6个月差异有统计学意义(均P<0.001)。结论PDR患者PPV术中联合抗VEGF药物玻璃体腔注射可减轻黄斑水肿,但对于视力及预防术后VH的发生无明显作用。Objective To observe the therapeutic effect of intravitreal injection of anti-vascular endothelial growth factor(VEGF)drugs during pars plana vitrectomy(PPV)in patients with proliferative diabetic retinopathy(PDR)to prevent postoperative vitreous hemorrhage(VH).Methods This was a retrospective case-control study.Clinical data of 60 cases(60 eyes)of PDR treated with PPV at Zhengzhou Second People’s Hospital from Jan.2023 to Nov.2023 were collected.Based on the treatment method,they were divided into two groups:an injection group(30 eyes)which received intravitreal injection of anti-VEGF drugs(ranibizumab)at the end of PPV and a control group(30 eyes)which did not receive intravitreal injection at the end of PPV.Best corrected visual acuity(BCVA,logMAR),VH,and macular center retinal thickness(CMT)before and after operation between the two groups were compared and analyzed.Results There were no difference in age,gender,intraocular pressure,BCVA,retinal laser,or retinal proliferative membrane between the two groups before surgery.BCVA of the injection group at preoperation,1 week,1 month,3 months,and 6 months postoperatively were 1.59±0.47,1.06±0.56,0.72±0.59,0.62±0.80,and 0.45±0.76,respectively.BCVA of the control group were 1.43±0.51,1.07±0.48,0.68±0.32,0.64±0.56,and 0.48±0.56,respectively.There were no statistically significant differences between the two groups at different time points(all P>0.05).At 1 one month after surgery,1 eye in the injection group and 4 eyes in the control group developed VH.At 3 and 6 months after surgery,1 eye in the injection group developed VH,respectively.There was no statistically significant difference between the two groups(all P>0.05).CMT were(349.97±19.75),(275.07±25.45),(264.81±69.76),and(254.54±54.56)μm in the injection group,and(347.30±24.55),(325.83±20.75),(365.45±89.86),and(325.24±96.35)μm in the control group at 1 week,1 month,3 months,and 6 months after surgery,respectively.There was no statistically significant difference between the two groups at 1

关 键 词：抗血管内皮生长因子 视网膜病变 糖尿病性 增生型 玻璃体积血 玻璃体切除术 

分 类 号：R779.6[医药卫生—眼科]