[1]赖江峰,彭　静,蓝诚红,等.雷珠单抗玻璃体腔注射联合玻璃体切割术治疗玻璃体积血疗效观察[J].新乡医学院学报,2020,37(7):691-695.[doi:10.7683/xxyxyxb.2020.07.022]
　LAI Jiangfeng,PENG Jing,LAN Chenghong,et al.Therapeutic effect of intravitreal injection of leizumab combined with vitrectomy in the treatment of vitreous hemorrhage[J].Journal of Xinxiang Medical University,2020,37(7):691-695.[doi:10.7683/xxyxyxb.2020.07.022]
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雷珠单抗玻璃体腔注射联合玻璃体切割术治疗玻璃体积血疗效观察
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
37
期数:
2020年7
页码:
691-695
栏目:
临床研究
出版日期:
2020-07-05

文章信息/Info

Title:
Therapeutic effect of intravitreal injection of leizumab combined with vitrectomy in the treatment of vitreous hemorrhage
作者:
赖江峰; 彭　静; 蓝诚红; 余兆敏; 李达佑
（梅州市人民医院眼一科 ，广东　梅州　514000）
Author(s):
LAI Jiangfeng; PENG Jing; LAN Chenghong; YU Zhaomin; LI Dayou
（Department of Ophthalmology,Meizhou People′s Hospital，Meizhou 514000，Guangdong Province，China）
关键词:
玻璃体积血; 玻璃体切割术; 雷珠单抗; 新生血管; 炎症反应; 眼压
Keywords:
vitreous hemorrhage; vitrectomy; ranibizumab; neovascularization; inflammatory response; intraocular pressure
分类号:
R776.4
DOI:
10.7683/xxyxyxb.2020.07.022
文献标志码:
A
摘要:
目的　探讨玻璃体腔注射雷珠单抗联合玻璃体切割术治疗玻璃体积血的临床疗效。方法　回顾性分析梅州市人民医院2016年3月至2018年5月收治的129例玻璃体积血患者的临床资料，按治疗方法将患者分为3组。注药组43例（49只眼）患者行玻璃体腔注射雷珠单抗治疗，玻切组43例（49只眼）患者行玻璃体切割术治疗，联合治疗组43例（51只眼）患者行玻璃体腔注射雷珠单抗联合玻璃体切割术治疗。分别于治疗前和治疗后1个月抽取患者患眼前房房水0.1 mL，采用酶联免疫法检测前房房水中血管内皮生长因子(VEGF)、超敏C反应蛋白（hs-CRP）水平；比较3组患者治疗前及治疗后1、3、6、12个月最佳矫正视力（BCVA）及眼内压；记录患者术中及术后并发症发生情况。结果　治疗前3组患者前房房水中VEGF、hs-CRP水平比较差异无统计学意义（P>0.05）。3组患者治疗后1个月前房房水中VEGF、hs-CRP水平均显著低于治疗前（P<0.01）。治疗后1个月，联合治疗组患者前房房水中VEGF、hs-CRP水平显著低于注药组和玻切组（P<0.05），注药组患者前房房水中VEGF、hs-CRP水平显著低于玻切组（P<0.05）。治疗前3组患者LogMAR BCVA比较差异无统计学意义（P>0.05）。3组患者治疗后LogMAR BCVA随时间的延长均逐渐降低（P<0.01）。联合治疗组患者治疗后各时间点LogMAR BCVA均显著低于注药组和玻切组（P<0.05），注药组和玻切组患者治疗后各时间点LogMAR BCVA比较差异无统计学意义（P>0.05）。治疗前3组患者眼内压比较差异无统计学意义（P>0.05）。3组患者治疗后各时间点之间眼内压比较差异均无统计学意义（P>0.05），且治疗后各时间点3组患者间眼内压比较差异无统计学意义（P>0.05）。注药组、玻切组和联合治疗组患者总并发症发生率分别为20.00%（3/15）、77.55%（38/49）、15.68%（8/51），联合治疗组患者总并发症发生率显著低于玻切组（χ2=12.294，P<0.01），联合治疗组与注药组患者总并发症发生率比较差异无统计学意义（χ2=1.068，P>0.05）；注药组与玻切组患者总并发症发生率比较差异无统计学意义（χ2=0.963，P>0.05）。结论　玻璃体切割术前玻璃体腔注射雷珠单抗能有效抑制新生血管形成，减缓眼部炎症反应，减少术中并发症，促进患者术后视力恢复。
Abstract:
Objective　To investigate the clinical effect of intravitreal injection of leizumab combined with vitrectomy in the treatment of vitreous hemorrhage.Methods　The clinical data of 129 patients with vitreous hemorrhage admitted to Meizhou People’s Hospital from March 2016 to May 2018 were retrospectively analyzed.They were divided into 3 groups according to the treatment methods.The 43 patients (49 eyes) in the drug injection group were received intravitreal injection of leizhumab,the 43 patients (49 eyes) in the vitrectomy group received vitrectomy,and 43 patients (51 eyes) in the combined treatment group received intravitreal injection of leizhumab and vitrectomy.The aqueous humor(0.1 mL) of anterior chamber was extracted from all patients before and 1 month after treatment and the levels of vascular endothelial growth factor (VEGF) and hypersensitive C-reactive protein (hs-CRP) in anterior aqueous humor were detected by enzyme-linked immunosorbent assay.The best corrected visual acuity(BCVA) and the intraocular pressure of patients before treatment and 1,3,6,12 months after treatment were compared among the three groups.The complications during and after operation were recorded.Results　There was no significant difference in the levels of VEGF and hs-CRP in the aqueous humor of anterior chamber of patients among the three groups before treatment (P>0.05).The levels of VEGF and hs-CRP in the aqueous humor of anterior chamber of patients at 1 month after treatment were significantly lower than those before treatment in the three groups (P<0.01).One month after the treatment,the levels of VEGF and hs-CRP in the aqueous humor of anterior chamber of patients in the combined treatment group were significantly lower than those in the drug injection group and the vitrectomy group (P<0.05);the levels of VEGF and hs-CRP in the aqueous humor of anterior chamber of patients in the drug injection group were significantly lower than those in the vitrectomy group (P<0.05).There was no significant difference in LogMAR BCVA among the three groups before treatment (P>0.05).After treatment,the LogMAR BCVA of patients in the three groups decreased with the increase of time (P<0.01).The LogMAR BCVA of patients in the combined treatment group was significantly lower than that in the drug injection group and the vitrectomy group at each time point after treatment (P<0.05);there was no significant difference in LogMAR BCVA of patients between the drug injection group and the vitrectomy group at each time point after treatment (P>0.05).There was no significant difference in the intraocular pressure of patients among the three groups before treatment (P>0.05).There was no significant difference in the intraocular pressure of patients among each time point after treatment in the three groups (P>0.05);there was no significant difference in the intraocular pressure of patients among the three groups at each time point after treatment (P>0.05).The total complication rate of patients in the drug injection group,vitrectomy group and the combined treatment group was 20.00% (3/15）,77.55%（38/49）,15.68%（8/51）respectively;the total incidence of complication of patients in the combination treatment group was significantly lower than that in the vitrectomy group (χ2= 12.294,P<0.01);there was no statistic difference in the total incidence of complication between the combination treatment group and the drug injection group (χ2=1.068,P>0.05).There was no significant difference in the total incidence of complications between the drug injection group and the vitrectomy group(χ2=0.963,P>0.05).Conclusion　The intravitreal injection of leizumab before vitrectomy can effectively inhibit the formation of neovascularization,lessen inflammatory reaction of eyes,reduce intraoperative complications,and promote postoperative visual recovery of patients.

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更新日期/Last Update: 2020-07-05