【摘要】：目的觀察玻璃體內(nèi)注射雷珠單抗聯(lián)合玻璃體切割術(shù)治療嚴(yán)重增生型糖尿病視網(wǎng)膜病變(proliferative diabetic retinopathy,PDR)的臨床效果。方法將臨床確診為嚴(yán)重PDR的患者52例72眼納入本研究。依據(jù)術(shù)前是否行玻璃體內(nèi)注射雷珠單抗將患者分為治療組和對(duì)照組:治療組30例42眼、對(duì)照組22例30眼。治療組術(shù)前3 d玻璃體內(nèi)注射10 g·L-1雷珠單抗0.05 mL(0.5 mg),然后行玻璃體切割術(shù),對(duì)照組直接行玻璃體切割術(shù)。術(shù)后隨訪3~12(6.5±1.3)個(gè)月。對(duì)比分析兩組患者視力、眼壓、黃斑中心凹視網(wǎng)膜厚度和術(shù)后并發(fā)癥的發(fā)生情況。結(jié)果治療組、對(duì)照組手術(shù)后視力分別為0.090±0.068、0.060±0.029,均較術(shù)前提高,2組治療前、治療后視力比較差異均有統(tǒng)計(jì)學(xué)意義(t=-5.005、-3.237,均為P0.05)。兩組術(shù)后視力比較,差異有統(tǒng)計(jì)學(xué)意義(t=2.034,P0.05)。治療組、對(duì)照組術(shù)后黃斑中心凹視網(wǎng)膜厚度分別為(313.8±27.3)μm、(325.6±14.5)μm,差異有統(tǒng)計(jì)學(xué)意義(t=-1.51,P0.05)。術(shù)后2周、1個(gè)月、3個(gè)月,治療組玻璃體積血發(fā)生率分別為12%、2%、2%,對(duì)照組發(fā)生率分別為27%、20%、3%;兩組術(shù)后各時(shí)間點(diǎn)發(fā)生率比較,術(shù)后2周及1個(gè)月之間差異均有統(tǒng)計(jì)學(xué)意義(χ2=3.42、3.21,均為P0.05),術(shù)后3個(gè)月差異無統(tǒng)計(jì)學(xué)意義(χ2=1.02,P0.05)。結(jié)論玻璃體切割術(shù)聯(lián)合玻璃體內(nèi)注射雷珠單抗治療嚴(yán)重PDR能提高患者視力,降低術(shù)后玻璃體積血發(fā)生率和黃斑中心凹視網(wǎng)膜厚度。
[Abstract]:Objective to observe the clinical effect of intravitreous injection of Leizhu monoclonal antibody combined with vitrectomy in the treatment of severe proliferative diabetic retinopathy (proliferative diabetic retinopathy). Methods 52 cases (72 eyes) with severe PDR were included in this study. The patients were divided into treatment group (n = 30) and control group (n = 42) according to whether intravitreous injection of Lei Zhu McAb was performed before operation: treatment group (n = 30) and control group (n = 22) (30 eyes). The treatment group was treated with vitrectomy 3 days before operation, and the control group was directly treated with vitrectomy. The treatment group was injected with 10 g L -1 Lei Zhu McAb 0. 05 mL (0. 5 mg),) and the control group was directly treated with vitrectomy. Postoperative follow-up was 3 weeks (6.5 鹵1.3) months. Visual acuity, intraocular pressure, macular central foveal retinal thickness and postoperative complications were compared between the two groups. Results the visual acuity of the treatment group and the control group were 0.090 鹵0.068 and 0.060 鹵0.029, respectively, which were significantly higher than those of the two groups before and after treatment (tng-5.005- 3.237, P0.05). The postoperative visual acuity of the two groups was significantly different (t = 2.034 P 0.05). The retinal thickness of macular fovea was (313.8 鹵27.3) 渭 m and (325.6 鹵14.5) 渭 m in the treatment group and control group, respectively. At 2 weeks, 1 month, 3 months after operation, the incidence of vitreous hemorrhage in the treatment group was 12 and that in the control group was 27. 20 and 3, respectively. The difference between 2 weeks and 1 month after operation was statistically significant (蠂 2 + 3.42 鹵3. 21, P0.05), but there was no significant difference 3 months after operation (蠂 2 + 1. 02 P 0.05). Conclusion vitrectomy combined with intravitreous injection of Lei Zhu McAb can improve the visual acuity and decrease the incidence of vitreous hemorrhage and retinal thickness of macular central fovea in patients with severe PDR.
【作者單位】： 石河子大學(xué)醫(yī)學(xué)院第一附屬醫(yī)院眼科;
【基金】：石河子大學(xué)醫(yī)學(xué)院第一附屬醫(yī)院院級(jí)課題(編號(hào):YL2010-Y003)~~
【分類號(hào)】：R779.6;R587.2

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