摘要
目的观察玻璃体内注射雷珠单抗联合玻璃体切割术治疗严重增生型糖尿病视网膜病变（proliferative diabetic retinopathy,PDR）的临床效果。方法将临床确诊为严重PDR的患者52例72眼纳入本研究。依据术前是否行玻璃体内注射雷珠单抗将患者分为治疗组和对照组：治疗组30例42眼、对照组22例30眼。治疗组术前3 d玻璃体内注射10 g·L-1雷珠单抗0.05 mL（0.5 mg）,然后行玻璃体切割术,对照组直接行玻璃体切割术。术后随访3~12（6.5±1.3）个月。对比分析两组患者视力、眼压、黄斑中心凹视网膜厚度和术后并发症的发生情况。结果治疗组、对照组手术后视力分别为0.090±0.068、0.060±0.029,均较术前提高,2组治疗前、治疗后视力比较差异均有统计学意义（t=-5.005、-3.237,均为P〈0.05）。两组术后视力比较,差异有统计学意义（t=2.034,P〈0.05）。治疗组、对照组术后黄斑中心凹视网膜厚度分别为（313.8±27.3）μm、（325.6±14.5）μm,差异有统计学意义（t=-1.51,P〈0.05）。术后2周、1个月、3个月,治疗组玻璃体积血发生率分别为12%、2%、2%,对照组发生率分别为27%、20%、3%;两组术后各时间点发生率比较,术后2周及1个月之间差异均有统计学意义（χ2=3.42、3.21,均为P〈0.05）,术后3个月差异无统计学意义（χ2=1.02,P〉0.05）。结论玻璃体切割术联合玻璃体内注射雷珠单抗治疗严重PDR能提高患者视力,降低术后玻璃体积血发生率和黄斑中心凹视网膜厚度。
Objective To observe the clinical effects of vitrectomy assisted with intravitreal injection of ranibizumab for severe proliferative diabetic retinopathy（PDR）. Methods A total of 52 patients （72 eyes） with severe PDR were enrolled, and divided into treatment group（ 30 patients ,42 eyes）and control group （22 patients, 30 eyes）. The patients in treatment group received an intravitreal injection of 0.05 mL ranibizumab so- lution（ 10 g · L^-1 ） firstly,and 3 or 4 days later they received vitrectomy. The patients in control group only received vitrectomy, The follow-up time was 3 months to 12 months with an average of （ 6.5 ± 1.3 ） months. The visual acuity, intraocular pressure, central retinal thickness （CRT） and incidence of postoperative complications were observed. Results The mean postoperative logMAR visual acuity in treatment group and control group were 0.09 ± 0.068 and 0.05 ± 0.029, which were all higher than pre-operation, the difference was statistically significant （ t = - 5. 005, - 3. 237, all P 〈 0.05 ）. The mean post-operative IogMAR visual acuity in treatment group was higher than that of control group,the difference was statistically significant（ t =2.034 ,P 〈0.05 ）. The average post- operative CRT in treatment group and control group were （ 313. 8 ± 27. 3 ） μm and （325.5 ± 14.5 ） μm, the difference was statistically significant （ t = - 1. 51, P 〈 0.05 ）. The incidences of postoperative vitreous hemorrhage in treatment group and control group were 12% and 27% at 2 weeks after surgery,2% and 20% at 1 month after surgery,2% and 3% at 3 months after surgery, respectively, the differences was statistically signifi- cant for 2 weeks （x^2 = 3.42,P 〈 0.05 ） and 1 month （ t = 3.21 ,P 〈 0.05 ）, but there was no statistical difference for 3 months （x^2 = 1.02,P 〉 0.05 ）. Conclusion Vitrectomy assis- ted with intravitreal injection of ranibizumab for severe PDR can effectively improve vis-ual acuity,prevent postoperative vitreous hemorrhage and reduce CRT.
出处
《眼科新进展》
CAS
北大核心
2015年第11期1064-1066,共3页
Recent Advances in Ophthalmology
基金
石河子大学医学院第一附属医院院级课题(编号:YL2010-Y003)~~
