摘要
目的探讨视网膜激光光凝术前予血管内皮生长因子(VEGF)抑制剂联合曲安奈德对视网膜分支静脉阻塞继发黄斑水肿(BRVO-ME)患者视网膜形态学的影响。方法选取医院2019年2月至2020年2月收治的BRVO-ME患者142例,按双盲法分为曲安奈德组和联合治疗组,各71例。术前两组患者均予曲安奈德注射液,联合治疗患者加用雷珠单抗注射液。结果与曲安奈德组比较,治疗后,联合治疗组患者sVEGFR-1 mRNA及sVEGFR-2 mRNA水平均显著降低(P<0.05);血清纤维蛋白原(Fib)、血浆黏度水平和红细胞聚集指数均显著降低(P<0.05);黄斑中心凹水肿厚度(CMT)显著降低,最佳矫正视力(BCVA)显著升高(P<0.05);黄斑中心凹1 mm直径范围内外界膜层、椭圆体带层视网膜形态学指标均显著降低(P<0.05)。联合治疗组治疗总有效率为95.77%,显著高于曲安奈德组的83.10%(P<0.05);曲安奈德组和联合治疗组患者不良反应发生率相当(7.04%比4.23%,P>0.05)。结论BRVO-ME患者视网膜激光光凝术前予VEGF抑制剂联合曲安奈德疗效较好,可改善患者的CMT及BCVA,降低Fib水平、血浆黏度和红细胞聚集指数,且不良反应较少。
Objective To investigate the effect of vascular endothelial growth factor inhibitor(VEGF)combined with triamcinolone acetonide on retinal morphology in patients with macular edema secondary to branch retinal vein occlusion(BRVO-ME)before undergoing retinal laser photocoagulation.Methods A total of 142 patients with BRVO-ME admitted to our hospital from February 2019 to February 2020 were selected and divided into triamcinolone acetonide group and combined group according to the double-blind method,71 cases in each group.Before the operation,the patients in the two groups were treated with Triamcinolone Acetonide Injection,on this basis,the patients in the combined group were treated with Ranibizumab Injection.Results After treatment,compared with those in the triamcinolone acetonide group,the sVEGFR-1 mRNA level and sVEGFR-2 mRNA level in the combined group significantly decreased(P<0.05),and the serum fibrinogen(Fib)level,plasma viscosity level and erythrocyte aggregation index in the combined group significantly decreased(P<0.05),the centre macular thickness(CMT)significantly decreased while the best-corrected visual acuity(BCVA)significantly increased in the combined group(P<0.05),the retinal morphological indexes of external limiting membrane(ELM)and elliptical zone(EZ)layer within 1 mm diameter of macular fovea in the combined group significantly decreased(P<0.05).The effective rate of the combined group was 95.77%,which was significantly higher than 83.10%of the triamcinolone acetonide group(P<0.05).The incidence of adverse reactions in the triamcinolone acetonide group was similar to that in the combined group(7.04%vs.4.23%,P>0.05).Conclusion Before undergoing retinal laser photocoagulation,VEGF combined with triamcinolone acetonide is effective in the treatment of patients with BRVO-ME,which can improve the CMT and BCVA,reduce the Fib level,plasma viscosity level and erythrocyte aggregation indexes with less adverse reactions.
作者
韩莎莎
张兰
张贺鹏
HAN Shasha;ZHANG Lan;ZHANG Hepeng(Department of Ophthalmology,Hengshui People's Hospital,Hengshui,Hebei,China 053000)
出处
《中国药业》
CAS
2021年第19期98-102,共5页
China Pharmaceuticals
基金
河北省医学科学研究重点课题[20191762]。
关键词
血管内皮生长因子抑制剂
曲安奈德
视网膜激光光凝术
视网膜分支静脉阻塞继发黄斑水肿
外层视网膜形态学
vascular endothelial growth factor inhibitor
triamcinolone acetonide
retinal laser photocoagulation
macular edema secondary to branch retinal vein occlusion
outer retinal morphology