雷珠单抗联合玻璃体切割术对PDR患者视网膜新血管形成的影响

摘要

目的 探讨雷珠单抗联合玻璃体切割术对增殖型糖尿病性视网膜病变(PDR)患者视网膜新血管形成的影响.方法 将90例PDR患者分为两组,每组45例.对照组采用玻璃体切割术治疗,研究组在玻璃体切割术前给予玻璃体注射雷珠单抗;对比两组手术基本情况及术后2个月恢复情况.结果 研究组手术时间、电凝止血次数、医源性裂孔个数、术中出血发生率均显著低于对照组,差异有统计学意义(t=4.467,χ2=5.404、6.672、6.273,P<0.05);两组治疗后最佳纠正视力(BCVA)、黄斑中心视网膜厚度(CMT)显著降低(P<0.05);研究组治疗后BCVA、CMT显著低于对照组,差异有统计学意义(t=6.566、3.027,P<0.05);两组治疗后血管内皮生长因子(VEGF)、人基质细胞衍生因子1(SDF-1)、细胞间黏附因子1(ICAM-1)水平显著降低(P<0.05);研究组治疗后VEGF、SDF-1、ICAM-1水平显著低于对照组,差异有统计学意义(t=7.506、10.035、7.340,P<0.05).结论 术前注射雷珠单抗能有效抑制PDR患者视网膜新血管生成,有助于提高玻璃体切割术的治疗效果.%Objective To investigate the effect of the combination of the monoclonal antibody and vitrectomy on the formation of new retinal blood vessels in patients with proliferative diabetic retinopathy (PDR).Methods A total of 90 cases of PDR were divided into two groups,45 cases in each group.The control group was treated with vitrectomy.The study group was given the vitreous injection of monoclonal antibody before vitrectomy.The basic situation of the two groups was compared two months after the operation.Results In the study group,the operation time,the frequency of coagulation and hemostasis,iatrogenic fracture and bleeding were significantly lower than those in the control group (t=4.467,χ2=5.404,6.672,6.273,P<0.05).Best cowelated visual acuity(BCVA) and central macular retinal thickness(CMT) were significantly decreased after treatment in two groups (P<0.05).After treatment,best corrected visual acuity (BCVA) and CMT in the study group were significantly lower than those in the control group after treatment (t=6.566,3.027,P<0.05).After treatment,the levels of vascular endothelial growth factor(VEGF),human stromal cell derived factor 1(SDF-1) and intercellular adhesion molecule 1(ICAM-1) were significantly lower in the two groups(P<0.05).After treatment,the levels of VEGF,SDF-1 and ICAM-1 in the study group were significantly lower than those in the control group after treatment(t=7.506,10.035,7.340,P<0.05).Conclusion Preoperative injection of monoclonal antibodies can effectively inhibit the formation of new retinal blood vessels in patients with PDR,and it is helpful to improve the therapeutic effect of vitrectomy.