经小梁切除术联合玻璃体腔内注射雷珠单抗治疗新生血管性青光眼临床效果及对视力和眼压的影响

doi:10.3969/j.issn.1006-6233.2023.04.020

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摘要 目的: 研究新生血管性青光眼(NVG)治疗中玻璃体腔内注射雷珠单抗疗法与经小梁切除术联用效果。方法: 以回顾性分析为法,观察对象为2020年1月至2022年1月入院的70例NVG患者,根据不同治法分为研究组(35例)与对照组(35例)。研究组行玻璃体腔内注射雷珠单抗疗法与经小梁切除术联合治疗,对照组行经小梁切除术治疗;比较两组治疗前与治疗3个月后眼压水平、视力水平、眼动脉血流动力学指标[血流阻力系数(RI)、收缩期峰值流速(PSV)、舒张末期流速(EDV)]、血清白细胞介素-6(IL-6)与治疗后总有效率、并发症(眼球疼痛、前房积血、低眼压、角膜水肿)发生率。结果: 治疗前,两组患者的眼压、视力、RI、PSV、EDV、IL-6水平差异无统计学意义(P>0.05);治疗后,两组患者的视力、PSV、EDV水平较治疗前升高,眼压、RI、IL-6水平较治疗前降低,差异有统计学意义(P<0.05);两组视力、PSV、EDV、眼压、RI、IL-6水平治疗前后差值比较,差异有统计学意义(P<0.05);研究组的总有效率较对照组升高,并发症发生率较对照组降低,差异有统计学意义(P<0.05)。结论: NVG治疗中玻璃体腔内注射雷珠单抗疗法与经小梁切除术联用效果显著,可有效提升患者视力,降低其眼压水平,还可改善眼动脉血流动力学及IL-6水平,减少并发症。

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	郭彬
	李金金

关键词 ：经小梁切除术, 玻璃体腔内注射, 雷珠单抗, 新生血管性, 青光眼

Abstract：Objective: To study the effect of intravitreal injection of ranibizumab therapy in combination with trans-trabeculectomy in the treatment of neovascular glaucoma (NVG). Methods: By retrospective analysis, 70 NVG patients admitted from January 2020 to January 2022 were enrolled and divided into experimental group (35 cases) and control group (35 cases) according to different treatment methods. The experimental group received intravitreal injection of ranibizumab combined with trans-trabeculectomy, while the control group received trans-trabeculectomy. The incidence of IOP levels, visual acuity levels, ocular arterial hemodynamic parameters [coefficient of resistance (RI), peak systolic flow velocity (PSV), end-diastolic flow velocity (EDV)], serum interleukin-6 (IL-6) and overall efficiency after treatment, complications (ocular pain, anterior chamber blood accumulation, hypotension, corneal edema) were compared between the two groups before treatment and after 3 months of treatment. Results: Before treatment, there were no significant differences in intraocular pressure, visual acuity, RI, PSV, EDV and IL-6 levels between the two groups (P>0.05). After treatment, the levels of visual acuity, PSV and EDV in 2 groups were higher than before, while the levels of intraocular pressure, RI and IL-6 were lower than before, with statistical significance (P<0.05). The differences of visual acuity, PSV, EDV, Intraocular pressure, RI and IL-6 before and after treatment were statistically significant between the two groups (P<0.05). The total effective rate of the experimental group was higher than that of the control group, and the complication rate was lower, the difference was statistically significant (P<0.05). Conclusion: Intravitreal injection of ranibizumab combined with trans-trabeculectomy has significant effect in NVG treatment, which can effectively improve visual acuity, reduce intraocular pressure, improve arterial hemodynamics and IL-6 levels, and reduce complications.

Key words： Trans-trabeculectomy Intravitreal injection Ranibizumab Neovascular Glaucoma

基金资助:2019年安徽高校自然科学研究项目,(编号:KJ2019ZD24)

引用本文:

郭彬, 李金金. 经小梁切除术联合玻璃体腔内注射雷珠单抗治疗新生血管性青光眼临床效果及对视力和眼压的影响[J]. 河北医学, 2023, 29(4): 626-630.
GUO Bin, LI Jinjin. Clinical Effects of Transcatheter Trabeculectomy Combined with Intravitreal Injection of Ranibizumab for Neovascular Glaucoma and the Effects on Visual Acuity and Intraocular Pressure. HeBei Med, 2023, 29(4): 626-630.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2023.04.020 或 http://www.hbyxzzs.cn/CN/Y2023/V29/I4/626

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