本文選題：視網(wǎng)膜靜脈阻塞　切入點(diǎn)：黃斑水腫　出處：《新鄉(xiāng)醫(yī)學(xué)院》2017年碩士論文

【摘要】：背景隨著人口老齡化的發(fā)展,與高血壓病、高血脂癥、糖尿病等疾病相關(guān)的視網(wǎng)膜病也逐漸增多,其中視網(wǎng)膜靜脈阻塞是僅次于糖尿病視網(wǎng)膜病變的第2位常見視網(wǎng)膜血管疾病。一直以來(lái)都是眼科臨床醫(yī)師面臨的難題。目前多種方法用于治療視網(wǎng)膜靜脈阻塞。其中玻璃體腔內(nèi)注射抗VEGF藥物是近年的熱點(diǎn),給眼底疾病的治療模式帶來(lái)了變革�？蛋匚髌�(conbercept)是我國(guó)自主研發(fā)的抗VEGF藥物,但目前用于RVO繼發(fā)黃斑水腫治療的臨床觀察報(bào)道尚不多。目的評(píng)價(jià)康柏西普玻璃體腔內(nèi)注射治療視網(wǎng)膜靜脈阻塞合并黃斑水腫的臨床療效,并對(duì)其影響因素進(jìn)行分析。方法前瞻性臨床自身對(duì)照研究。選擇本院2014年11月至2016年7月收治的確診為視網(wǎng)膜靜脈阻塞(RVO)合并黃斑水腫(ME)的36例(36眼)患者,給予玻璃體腔內(nèi)注射康柏西普治療,觀察其療效、分析其影響因素。所有患者均用眼科常規(guī)檢查方法及光學(xué)相干斷層掃描(OCT),觀察治療前后最佳矯正視力(BCVA)、黃斑中心凹厚度(CMT)等變化,評(píng)價(jià)其治療效果,并對(duì)年齡、病程及CMT等因素進(jìn)行相關(guān)分析。結(jié)果1.半年后檢查BCVA均不同程度提高,其中視力穩(wěn)定16例,視力提高有效20例;治療前平均BCVA(LogMAR值)為1.01±0.46,治療后半年平均BCVA(LogMAR值)為0.66±0.45,(t=7.689,P0.05)差異有統(tǒng)計(jì)學(xué)意義;患者CMT均不同程度變薄,治療前CMT 595.39±200.94μm,治療后CMT 268.36±84.86μm,(t=11.602,P0.05)差異有統(tǒng)計(jì)學(xué)意義。2.相關(guān)因素分析結(jié)果:治療效果與發(fā)病時(shí)間呈負(fù)相關(guān)(r=-0.573,P0.05)。CMT平均減輕厚度與治療前CMT呈正相關(guān)(r=0.909,P0.05)。3.治療過(guò)程中未見藥物相關(guān)副作用和全身不良反應(yīng),未見眼內(nèi)炎、視網(wǎng)膜撕裂、白內(nèi)障等玻璃體腔注射相關(guān)的眼部并發(fā)癥。結(jié)論1.玻璃體腔注射康柏西普治療視網(wǎng)膜靜脈阻塞合并黃斑水腫安全有效;2.發(fā)病時(shí)間越短,視力改善越明顯;治療前黃斑水腫越明顯,其促進(jìn)水腫吸收的效果越好,但長(zhǎng)期治療效果需進(jìn)一步觀察。
[Abstract]:Background with the development of aging population, retinopathy associated with hypertension, hyperlipidemia, diabetes and other diseases is also gradually increasing. Retinal vein occlusion is the second most common retinal vascular disease after diabetic retinopathy. It has always been a difficult problem for ophthalmologists. At present, many methods are used to treat retinal vein occlusion. Among them, intravitreal injection of anti- VEGF drugs is a hot spot in recent years. It has brought about a change in the treatment mode of fundus disease. Compactopril Conberceptis is an anti- VEGF drug developed independently in China. At present, there are few clinical reports on the treatment of macular edema secondary to RVO. Objective to evaluate the clinical effect of intravitreal injection of Compacipe in the treatment of retinal vein occlusion with macular edema. Methods 36 patients (36 eyes) who were diagnosed as retinal vein occlusion (RVO) with macular edema (MEM) from November 2014 to July 2016 were enrolled in this study. To observe the effect of intravitreous injection of Compactopril, The influencing factors were analyzed. All the patients were examined by routine ophthalmic examination and optical coherence tomography (Oct). The changes of BCVAV and CMT before and after treatment were observed, and the therapeutic effect was evaluated, and the age was evaluated. Results 1. After half a year, the BCVA was improved in different degree, the visual acuity was stable in 16 cases, and the visual acuity was improved in 20 cases. The average BCVA(LogMAR value before treatment was 1.01 鹵0.46, and the average BCVA(LogMAR value half a year after treatment was 0.66 鹵0.45U (P 0.05). There was significant difference in CMT 595.39 鹵200.94 渭 m before treatment and 268.36 鹵84.86 渭 m after treatment (P 0.05). The results of correlation factor analysis showed that there was a negative correlation between the effect of treatment and the onset time. There was a positive correlation between the average thickness of CMT before treatment and CMT before treatment. Effects and systemic adverse reactions, There were no intraocular complications associated with intravitreal injection, such as endophthalmitis, retinal tear and cataract. Conclusion 1. It is safe and effective to treat retinal vein occlusion with macular edema by intravitreal injection. The more obvious the improvement of visual acuity and the more obvious macular edema before treatment, the better the effect of promoting edema absorption, but the long-term therapeutic effect needs further observation.
【學(xué)位授予單位】：新鄉(xiāng)醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R774.1

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