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[摘要]
目的 探討玻璃體腔注射康柏西普治療對(duì)滲出性老年黃斑變性(eAMD)患者的臨床療效及房水中血管內(nèi)皮生長(zhǎng)因子(VEGF)、色素上皮細(xì)胞衍生因子(PEDF)水平的變化。方法 選取2013年5月—2017年4月在西電集團(tuán)醫(yī)院眼科治療的eAMD患者75例(75眼)作為研究對(duì)象,隨機(jī)分為治療組和對(duì)照組,分別有38、37例。治療組患者玻璃體腔注入0.05 mL康柏西普注射液,對(duì)照組患者注入0.5 mL曲安奈德注射液,比較兩組患者治療前后最佳矯正視力(BCVA)、黃斑中心凹視網(wǎng)膜厚度(CRT)以及房水中VEGF、PEDF濃度,并觀察術(shù)后并發(fā)癥的發(fā)生情況。結(jié)果 治療前,兩組BCVA、CRT、房水中VEGF、PEDF濃度均無(wú)顯著差異;術(shù)后1、3、6個(gè)月治療組BCVA、CRT均顯著高于治療前,同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義(P<0.05),而對(duì)照組無(wú)顯著變化。治療后治療組VEGF顯著降低、PEDF顯著升高,同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義(P<0.05),而對(duì)照組無(wú)顯著變化。兩組治療期間不良反應(yīng)的發(fā)生情況比較無(wú)顯著差異。結(jié)論 玻璃體腔注射康柏西普可以顯著降低eAMD患者房水中VEGF濃度,提高PEDF水平,改善視力,療效顯著,且無(wú)嚴(yán)重的并發(fā)癥,值得臨床應(yīng)用和推廣。
[Key word]
[Abstract]
Objective To explore the clinical efficacy of intravitreal injection of conbercept in the treatment of eAMD and the changes of VEGF and PEDF in aqueous humor. Methods Selected 75 patients (75 eyes) with eAMD in our hospital from May 2013 to April 2017. All patients were randomly divided into treatment group and control group, each group 37, 38 cases. The levels of VEGF and PEDF in aqueous humor, BCVA, CRT were compared before and after treatment, and the occurrence of postoperative complications was observed. Results There was no significant difference in BCVA, CRT and VEGF and PEDF levels before treatment. The levels of BCVA and CRT in the treatment group were significantly higher than those before treatment (P < 0.05), but there was no significant change in the control group. The levels of VEGF were significantly decreased and PEDF was significantly increased in the treatment group after treatment (P < 0.05), but there was no significant change in the control group. There was no significant difference in the incidence of adverse reactions between the two groups. Conclusions Intravitreal injection of Conbercept can significantly reduce the concentration of VEGF in patients with eAMD, improve the level of PEDF. The therapy method can improve vision, significant effect, and no serious complications, worthy of clinical application and promotion.
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