摘要
目的 探讨不同剂量术前雷珠单抗对增殖性糖尿病性视网膜病变(PDR)患者手术效果及眼部安全影响。方法 将2019年6月至2022年3月洛阳市第三人民医院收治的PDR患者102例按随机数表法分为3组,其中单纯玻切组(34例)采用玻璃体切除术(PPV),半量组(34例)采用术前注射0.25 mg/0.025 mL雷珠单抗+PPV术,标准组(34例)采用术前注射0.5 mg/0.05 mL雷珠单抗+PPV术。比较3组围术期指标(术中出血量、术中硅油使用率、电凝次数、术后眼压及手术时间),术前术后血清碱性成纤维细胞生长因子(bFGF)、血管内皮生长因子(VEGF)及血管内皮钙黏蛋白(VE)水平及术后并发症发生情况。结果 标准组及半量组术中出血量、电凝次数及手术时间,较单纯玻切组降低(P<0.05);标准组术后眼压与硅油使用率均低于单纯玻切组及半量组(P<0.05);标准组与半量组VEGF、bFGF及VE水平均明显低于单纯玻切组(P<0.05),且标准组VEGF水平较单纯玻切组低(P<0.05);标准组及半量组并发症发生率明显低于单纯玻切组(P=0.0125)。结论 术前玻璃体内注射雷珠单抗可有效降低进行玻璃体切除术的PDR患者血清中生长因子水平,并于保障用药安全同时提高手术进展,但高剂量注射整体效果略佳于低剂量。
Objective To investigate the effect of preoperative dosage of ralizumab on surgical outcome and ocular safety in patients with proliferative diabetic retinopathy(PDR).Methods A total of 102 patients with PDR admitted to The Third People's Hospital of Luoyang from June 2019 to March 2022 were divided into three groups according to random number table method.The control group(34 cases) received vitrectomy only(PPV),and the half-volume group(34 cases) received 0.25 mg/0.025 mL radizumab +PPV before surgery,and the standard group(34 cases) received 0.5 mg/0.05 mL ralizumab +PPV before operation.The perioperative indexes(intraoperative blood loss,intraoperative silicone oil utilization rate,times of electric coagulation,postoperative intraocular pressure and operation time),preoperative and postoperative serum Levels of bFGF,VEGF and VE,and the incidence of postoperative complications were compared among the three groups.Results Compared with the control group,the amount of blood loss,times of electrocoagulation and operation time in standard group and half group were lower(P<0.05).The postoperative intraocular pressure and silicone oil utilization rate in standard group were lower than that of control group and half-volume group(P<0.05,P<0.0125).The levels of VEGF,bFGF and VE in standard group and half volume group were significantly lower than those in control group(P<0.05),and the level of VEGF in standard group was lower than that of control group(P<0.05).The complication rate of standard group and half-volume group was significantly lower than that of control group(P<0.0125).Conclusions Preoperative vitreous injection of ralizumab can effectively reduce serum growth factor levels in PDR patients undergoing vitrectomy,and ensure drug safety and improve surgical progress,but the overall effect of high dose injection is slightly better than that of low dose.
作者
马恒哲
孙新
MA Heng-zhe;SUN xin(Department of Ophthalmology,The Third People's Hospital of Luoyang,Luoyang,Henan 471000,China;Department of Information,The Third People's Hospital of Luoyang,Luoyang,Henan 471000,China)
出处
《医药论坛杂志》
2023年第7期23-26,32,共5页
Journal of Medical Forum
基金
2022年度河南省医学科技攻关计划项目(LHGJ20220964)。
