[1]盛小红,辛向阳,王利明,等.雷珠单抗联合曲安奈德治疗湿性年龄相关性黄斑变性疗效观察[J].新乡医学院学报,2020,37(2):131-135.[doi:10.7683/xxyxyxb.2020.02.007]
　SHENG Xiaohong,XIN Xiangyang,WANG Liming,et al.Therapeutic effect of ranibizumab combined with triamcinolone acetonide for wet age-related macular degeneration[J].Journal of Xinxiang Medical University,2020,37(2):131-135.[doi:10.7683/xxyxyxb.2020.02.007]
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雷珠单抗联合曲安奈德治疗湿性年龄相关性黄斑变性疗效观察
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
37
期数:
2020年2
页码:
131-135
栏目:
临床研究
出版日期:
2020-02-05

文章信息/Info

Title:
Therapeutic effect of ranibizumab combined with triamcinolone acetonide for wet age-related macular degeneration
作者:
盛小红1; 辛向阳1; 王利明1; 孙　妍1; 李晓华2
（1.内蒙古包钢医院眼科，内蒙古　包头　014010；2.河南省立眼科医院眼科，河南　郑州　450000）
Author(s):
SHENG Xiaohong1; XIN Xiangyang1; WANG Liming1; SUN Yan1; LI Xiaohua2
(1.Department of Ophthalmology,Inner Mongolia Baotou Steel Hospital,Baotou 014010,Inner Mongolia,China；2.Department of Ophthalmology,Henan Provincial Eye Hospital,Zhengzhou 450000,Henan Province,China)
关键词:
湿性年龄相关性黄斑变性; 雷珠单抗; 曲安奈德; 白细胞介素
Keywords:
wet age-related macular degeneration; ranibizumab; triamcinolone acetonide; interleukin
分类号:
R771
DOI:
10.7683/xxyxyxb.2020.02.007
文献标志码:
A
摘要:
目的　观察雷珠单抗联合曲安奈德治疗湿性年龄相关性黄斑变性（AMD）的临床效果。方法　选择2017年11月至2018年10月内蒙古包钢医院眼科收治的86例（102眼）湿性AMD患者，采用随机数字表法分为对照组（43例，50眼）和观察组（43例，52眼）。对照组患者给予雷珠单抗注射液0.05 mL玻璃体腔注射，观察组患者给予雷珠单抗注射液0.05 mL和曲安奈德0.05 mL玻璃体腔注射，均每4周1次，连续3次。比较2组患者治疗前、治疗后2周及1、3个月的眼压值；比较2组患者治疗前、治疗后1、3、6个月黄斑中心凹厚度（CMT）、最佳矫正视力（BCVA）；比较2组患者治疗前、治疗后1个月血清白细胞介素（IL）-1β、IL-2、IL-6、IL-8水平；比较2组患者治疗及随访期间并发症发生情况。结果　2组患者治疗前、治疗后2周及治疗后1、3个月眼压值组间、组内比较差异均无统计学意义（P＞0.05）。治疗前2组患者CMT、BCVA及血清IL-1β、IL-2、IL-6、IL-8水平比较差异均无统计学意义（P＞0.05）。2组患者CMT随时间延长均呈降低趋势，BCVA随时间延长均呈升高趋势，组内两两比较差异均有统计学意义（P＜0.05）。治疗后1、3、6个月，观察组患者CMT均低于对照组（P＜0.05），BCVA均显著高于对照组（P＜0.05）。治疗后1个月，2组患者血清IL-1β、IL-6、IL-8水平显著低于治疗前（P＜0.05），血清IL-2水平显著高于治疗前（P＜0.05），且观察组患者血清IL-1β、IL-6、IL-8水平显著低于对照组（P＜0.05），血清IL-2水平显著高于对照组（P＜0.05）。随访6个月，对照组50眼中，发生出血1眼（2.00%），眼内异物感1眼（2.00%），一过性眼压升高2眼（4.00%），并发症发生率为8.00%（4/50）；观察组52眼中，发生出血2眼（3.85%），眼内异物感3眼（5.77%），一过性眼压升高0眼（0.00%），并发症发生率为9.62%（5/52）。2组患者出血、眼内异物感、一过性眼压升高发生率及并发症发生率比较差异均无统计学意义（χ2=0.304、0.961、2.100、0.083，P＞0.05）。结论　玻璃体腔注射雷珠单抗联合曲安奈德可有效降低湿性AMD患者的CMT，缓解炎症反应程度，改善视觉功能，且未造成眼压波动，安全可靠。
Abstract:
Objective　To observe the clinical efficacy of ranibizumab combined with triamcinolone acetonide for wet age-related macular degeneration (AMD).Methods　A total of 84 patients (102 eyes) with wet AMD admitted to the Department of Ophthalmology,Inner Mongolia Baotou Steel Hospital from November 2017 to October 2018 were selected and randomly divided into control group (43 cases,50 eyes) and observation group (43 cases,52 eyes).The 0.05 mL ranibizumab injection was injected into the intravitreal of patients in the control group;the 0.05 mL ranibizumab injection and 0.05 mL triamcinolone acetonide were injected into the intravitreal of patients in the observation group;once every four weeks for three times.The intraocular pressure values of patients were observed and compared between the two groups before treatment,at 2 weeks,1 month and 3 months after treatment.The central retinal thickness (CMT) and best corrected visual acuity (BCVA) of patients were compared between the two groups before treatment,1 month,3 months and 6 months after treatment.The serum levels of interleukin (IL)-1β,IL-2,IL-6 and IL-8 were compared between the two groups before treatment and at 1 month after treatment.The complications of patients were observed and compared between the two groups during the treatment and follow-up.Results　There was no significant difference in the intraocular pressure between the two groups before treatment,at 2 weeks,1 month and 3 months after treatment (P>0.05),and there was no significant difference in the intraocular pressure among all time point in the two group(P>0.05).There was no significant difference in the CMT,BCVA and serum levels of IL-1β,IL-2,IL-6,IL-8 between the two groups before treatment (P>0.05).The CMT decreased and BCVA increased with the increasing of time in the two groups (P<0.05).At 1,3,6 months after treatment,the CMT of patients in the observation group was lower than that in the control group (P＜0.05),while the BCVA of patients in the observation group was higher than that in the control group (P<0.05).The serum levels of IL-1β,IL-6 and IL-8 of patients at 1 month after treatment were significantly lower than those before treatment in the two groups (P<0.05),but the serum level of IL-2 was significantly higher than that before treatment (P<0.05).Compared with control group,the serum levels of IL-1β,IL-6 and IL-8 of patients in the observation group decreased,but the serum level of IL-2 increased at 1 month after treatment(P<0.05).After 6 months of follow-up,in 50 eyes of patients in the control group,bleeding occurred in 1 eye (2.00%),foreign body sensation occurred in 1 eye (2.00%),transient intraocular pressure rise in 2 eyes (4.00%),and the incidence of complications was 8.00% (4/50);in 52 eyes of patients in the observation group,bleeding occurred in 2 eyes (3.85%),foreign body sensation occurred in 3 eyes (5.77%),transient intraocular pressure rise occurred in 0 eyes (0.00%),and the incidence of complications was 9.62% (5/52).There was no significant difference in the incidence of bleeding,foreign body sensation,transient intraocular pressure rise and the total incidence of complications between the two groups (χ2= 0.304,0.961,2.100,0.083;P>0.05).Conclusions　Intravitreal injection of ranibizumab and triamcinolone acetonide can effectively reduce the CMT of wet AMD patients;it can relieve inflammation response,improve visual function,and not cause the fluctuation of intraocular pressure;so,it is safe and reliable

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更新日期/Last Update: 2020-02-05