【摘要】：目的研究雷珠單抗預(yù)防伴有虹膜新生血管的糖尿病視網(wǎng)膜病變玻璃體切割術(shù)后再出血的療效。方法回顧性分析2009年至2015年在我院因糖尿病視網(wǎng)膜病變行玻璃體切割術(shù)后出現(xiàn)虹膜新生血管的患者70例(70眼)的臨床資料。對照組30例(30眼)行全視網(wǎng)膜激光光凝,多次玻璃體手術(shù)、睫狀體冷凍等治療,研究組40例(40眼)術(shù)前玻璃體內(nèi)注射雷珠單抗0.5 mg后聯(lián)合各項治療,隨訪3個月,對比分析兩組患者視力、眼壓、新生血管消退及并發(fā)癥等情況。結(jié)果術(shù)后1個月、2個月時,研究組視力優(yōu)于對照組,但隨著時間的延長,兩組視力無明顯差異。研究組、對照組術(shù)前眼壓分別為(26.312±4.566)mmHg(1 kPa=7.5 mmHg)、(25.586±5.783)mmHg,兩組相比差異無統(tǒng)計學意義(P=0.687);隨訪期末眼壓分別為(18.576±4.762)mmHg、(28.587±7.786)mmHg,兩組相比差異有統(tǒng)計學意義(P=0.041)。對照組術(shù)中、術(shù)后出現(xiàn)前房和(或)玻璃體積血者分別為12例、5例,研究組為3例、1例,兩組術(shù)中、術(shù)后積血比例相比差異均有統(tǒng)計學意義(均為P=0.000)。隨訪期末研究組3眼(7.5%)進展為新生血管性青光眼,對照組為10眼(33.3%),兩組相比差異有統(tǒng)計學意義(P0.05)。結(jié)論糖尿病視網(wǎng)膜病變術(shù)后伴有虹膜新生血管時,雷珠單抗可以有效消除新生血管,減少新生血管性青光眼的發(fā)生率,并減少前房、玻璃體積血的發(fā)生率,在一定時間內(nèi)有效提高患者視力。
[Abstract]:Objective to study the effect of Leizhu McAb on preventing rebleeding after vitrectomy for diabetic retinopathy with iris neovascularization. Methods the clinical data of 70 patients (70 eyes) with iris neovascularization after vitrectomy in our hospital from 2009 to 2015 were retrospectively analyzed. 30 cases (30 eyes) in the control group were treated with laser photocoagulation, multiple vitreous surgery and ciliary body freezing. 40 cases (40 eyes) in the study group received intravitreous injection of Lei Zhu McAb 0.5 mg before operation and were followed up for 3 months. Visual acuity, intraocular pressure, neovascularization and complications were compared between the two groups. Results the visual acuity of the study group was better than that of the control group at 1 and 2 months postoperatively, but there was no significant difference in visual acuity between the two groups with the prolongation of time. In the study group, intraocular pressure (IOP) in the control group was (26.312 鹵4.566) mmHg (1 kPa=7.5 mmHg), (25.586 鹵5.783) mmHg, before operation respectively. There was no significant difference between the two groups (P < 0. 687). Intraocular pressure (IOP) was (18.576 鹵4.762) mmHg, (28.587 鹵7.786) mmHg, at the end of follow-up. In the control group, there were 12 cases and 5 cases of anterior chamber and / or vitreous hemorrhage in the control group, 3 cases in the study group and 1 case in the study group. There was significant difference between the two groups in the proportion of postoperative hemorrhage (P 0.000). At the end of follow-up, 3 eyes (7.5%) developed neovascular glaucoma in the study group and 10 eyes (33.3%) in the control group. The difference between the two groups was statistically significant (P0.05). Conclusion when diabetic retinopathy is associated with iris neovascularization after operation, Lei Zhu McAb can effectively eliminate neovascularization, reduce the incidence of neovascular glaucoma, and reduce the incidence of volume blood in anterior chamber and glass. Improve the visual acuity of patients effectively in a certain time.
【作者單位】： 南昌大學第二附屬醫(yī)院眼科;南昌大學第一附屬醫(yī)院血液內(nèi)科;
【基金】：國家自然科學基金資助(編號:81460088)~~
【分類號】：R587.2;R779.6

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