本文選題：雷珠單抗 + 全視網(wǎng)膜光凝��； 參考：《眼科新進(jìn)展》2017年08期

【摘要】：目的探討雷珠單抗玻璃體內(nèi)注射聯(lián)合全視網(wǎng)膜激光光凝治療重度非增生型糖尿病視網(wǎng)膜病變的臨床療效。方法將本院2014年7月至2016年6月收治的重度非增生型糖尿病視網(wǎng)膜病變患者64例(90眼),隨機(jī)分為兩組:對(duì)照組32例(44眼)單純采用全視網(wǎng)膜激光光凝(panretinal photocoagulation,PRP)治療,觀(guān)察組32例(46眼)采用玻璃體內(nèi)注射雷珠單抗聯(lián)合PRP治療,觀(guān)察兩組治療前,治療后1個(gè)月、3個(gè)月、6個(gè)月的最佳矯正視力(best corrected visual acuity,BCVA)、眼底、眼底熒光血管造影(fundus fluorescein angiography,FFA)、黃斑區(qū)視網(wǎng)膜神經(jīng)上皮層厚度和黃斑區(qū)6 mm直徑神經(jīng)上皮總體容積,記錄并計(jì)算治療中的激光能量、光斑數(shù)和能量密度,對(duì)上述數(shù)據(jù)進(jìn)行比較。結(jié)果對(duì)照組和觀(guān)察組患者治療后1個(gè)月、3個(gè)月、6個(gè)月時(shí)BCVA均優(yōu)于治療前(均為P0.05),并且觀(guān)察組患者治療后1個(gè)月、3個(gè)月、6個(gè)月時(shí)BCVA均優(yōu)于對(duì)照組(均為P0.05);對(duì)照組治療后6個(gè)月時(shí)BCVA與治療后3個(gè)月比較,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05),其他時(shí)間點(diǎn)比較差異均有統(tǒng)計(jì)學(xué)意義(均為P0.05);觀(guān)察組治療后各時(shí)間點(diǎn)比較差異均有統(tǒng)計(jì)學(xué)意義(均為P0.05)。黃斑區(qū)視網(wǎng)膜神經(jīng)上皮層平均厚度和黃斑區(qū)6 mm直徑神經(jīng)上皮總體容積的對(duì)比中,對(duì)照組和觀(guān)察組治療前后比較、治療后兩組中不同時(shí)間點(diǎn)之間比較差異均有統(tǒng)計(jì)學(xué)意義(均為P0.05)。并且觀(guān)察組患者治療后1個(gè)月、3個(gè)月、6個(gè)月時(shí)黃斑區(qū)視網(wǎng)膜神經(jīng)上皮層厚度、黃斑區(qū)6 mm直徑神經(jīng)上皮總體容積均優(yōu)于對(duì)照組(均為P0.05)。觀(guān)察組在激光能量、光斑數(shù)和能量密度均顯著低于對(duì)照組(均為P0.05)。結(jié)論玻璃體內(nèi)注射雷珠單抗聯(lián)合PRP治療重度非增生型糖尿病視網(wǎng)膜病變,利用較少的激光能量,可在較短時(shí)間內(nèi)加快視網(wǎng)膜新生血管的消退、減輕黃斑水腫并改善患者的視功能,其療效優(yōu)于單純應(yīng)用PRP治療,值得臨床推廣。
[Abstract]:Objective to investigate the clinical effect of intravitreous injection of Leizhu monoclonal antibody combined with total retinal laser photocoagulation in the treatment of severe nonproliferative diabetic retinopathy. Methods Sixty-four patients with severe non-proliferative diabetic retinopathy from July 2014 to June 2016 were randomly divided into two groups: the control group (32 cases, 44 eyes) and the control group (32 cases, 44 eyes) were treated with panretinal photocoagulation alone (PRP). 32 cases (46 eyes) in the observation group were treated with intravitreous injection of Lei Zhu McAb combined with PRP. The best corrected visual acuity before, 1 month, 3 months and 6 months after treatment were observed in both groups. Fundus fluorescein angiography, the thickness of retinal neuroepithelial layer in macular area and the total volume of neuroepithelium in macular area 6 mm in diameter were recorded and calculated. The laser energy, the number of spots and the energy density were recorded and calculated, and the above data were compared. Results the BCVA of the control group and the observation group was better than that of the control group at 1 month, 3 months and 6 months after treatment (P 0.05), and the BCVA of the observation group was better than that of the control group at 1 month, 3 months and 6 months after treatment. BCVA was compared at 6 months after treatment with that at 3 months after treatment. There was no statistical difference (P 0.05), but there was significant difference in other time points (all P 0.05), and there was significant difference in observation group (P 0.05) after treatment. The mean thickness of retinal nerve epithelium in macular area and the total volume of 6 mm diameter neuroepithelium in macular area were compared between the control group and the observation group before and after treatment. After treatment, there were significant differences between the two groups at different time points (P 0.05). The retinal neuroepithelial layer thickness of macular area and the total volume of 6 mm diameter neuroepithelium of macular area in the observation group were better than those in the control group at 1 month, 3 months and 6 months after treatment (all P 0.05). The laser energy, spot number and energy density in the observation group were significantly lower than those in the control group (P 0.05). Conclusion intravitreous injection of Lei Zhu McAb combined with PRP in the treatment of severe non-proliferative diabetic retinopathy can accelerate retinal neovascularization in a short time by using less laser energy. The curative effect of reducing macular edema and improving the visual function of patients is better than that of PRP alone, and it is worth popularizing clinically.
【作者單位】： 福建省寧德市閩東醫(yī)院眼科;福建省寧德市閩東醫(yī)院消化內(nèi)科;
【分類(lèi)號(hào)】：R587.2;R779.63

【相似文獻(xiàn)】

相關(guān)期刊論文 前1條

1 段海霞;劉玲;王班偉;杜振亞;;辛伐他汀治療高血脂非增生型糖尿病視網(wǎng)膜病變的效果研究[J];中國(guó)當(dāng)代醫(yī)藥;2013年20期

相關(guān)會(huì)議論文 前1條

1 楊亞敏;董曉光;謝立信;;增生型糖尿病視網(wǎng)膜病變患者玻璃體中血小板反應(yīng)蛋白-1和血管內(nèi)皮生長(zhǎng)因子的表達(dá)[A];中國(guó)眼底病論壇·全國(guó)眼底病專(zhuān)題學(xué)術(shù)研討會(huì)論文匯編[C];2008年

，

本文編號(hào)：1832998