[1]孙丽丽,季拓.贝伐单抗联合全视网膜光凝治疗增生型糖尿病视网膜病变的疗效观察[J].眼科新进展,2016,36(10):949-952.[doi:10.13389/j.cnki.rao.2016.0254]
　SUN Li-Li,JI Tuo.Effects of bevacizumab combined with panretinal photocoagulation on proliferative diabetic retinopathy[J].Recent Advances in Ophthalmology,2016,36(10):949-952.[doi:10.13389/j.cnki.rao.2016.0254]
点击复制

贝伐单抗联合全视网膜光凝治疗增生型糖尿病视网膜病变的疗效观察
分享到：

《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
36卷
期数:
2016年10期
页码:
949-952
栏目:
应用研究
出版日期:
2016-10-05

文章信息/Info

Title:
Effects of bevacizumab combined with panretinal photocoagulation on proliferative diabetic retinopathy
作者:
孙丽丽; 季拓
121000　辽宁省锦州市，辽宁医学院附属第三医院眼科（孙丽丽）；121000　辽宁省锦州市，辽宁医学院附属第一医院医务部（季拓）
Author(s):
SUN Li-Li; JI Tuo
Department of Ophthalmology , the Third Affiliated Hospital of Liaoning Medical University ( SUN Li-Li ) . Jinzhou 121 000 , Liaoning Province , China ; the First Affiliated Hospital of Liaoning Medical University ( JI Tuo ) . Jinzhou 121000 . Liaoning Province , China
关键词:
增生型糖尿病视网膜病变; 贝伐单抗; 全视网膜光凝; 视网膜新生血管
Keywords:
proliferative diabetic retinopathy ;  bevacizumab ; panretinal photocoagulation ;  retinal neovascularization
分类号:
Ｒ７７４.１
DOI:
10.13389/j.cnki.rao.2016.0254
文献标志码:
A
摘要:
目的　检测贝伐单抗玻璃体内注射疗法（ｂｅｖａｃｉｚｕｍａｂｉｎｊｅｃｔｉｏｎｓｉｎｖｉｔｒｅｏｕｓ，ＩＶＢ）对增生型糖尿病视网膜病变（ｐｒｏｌｉｆｅｒａ-ｔｉｖｅｄｉａｂｅｔｉｃｒｅｔｉｎｏｐａｔｈｙ，ＰＤＲ）中视网膜新生血管（ｒｅｔｉｎａｌｎｅｏｖａｓｃｕｌａｒｉｚａｔｉｏｎ，ＲＮＶ）的消退作用；评估ＩＶＢ联合全视网膜光凝（ｐａｎ-ｒｅｎｔｉｎａｌｐｈｏｔｏｃｏａｇｕｌａｔｉｏｎ，ＰＲＰ）对ＰＤＲ的临床疗效和安全性。方法　本研究收集行ＰＲＰ的ＰＤＲ患者７２例（７２眼），根据术前是否ＩＶＢ分为注射组和对照组，注射组在完成ＩＶＢ１．２５ｍｇ后第７天行眼底荧光血管造影（ｆｕｎｄｕｓｆｌｕｏｒｅｓｃｅｉｎａｎｇｉｏｇｒａｐｈｙ，ＦＦＡ）检查，并于当天开始第一个象限的ＰＲＰ，每周１次，共４次完成ＰＲＰ；对照组每周１次，共４次完成ＰＲＰ。两组患者均于ＰＲＰ后４周、８周、１２周复诊，并复查最佳矫正视力（ｂｅｓｔｃｏｒｒｅｃｔｅｄｖｉｓｕａｌａｃｕｉｔｙ，ＢＣＶＡ）、眼压、ＦＦＡ、光学相干断层扫描、眼前节及眼底。结果　注射组ＩＶＢ后１周，ＢＣＶＡ提高，ＲＮＶ渗漏面积减少，与治疗前差异有统计学意义（Ｐ＜０．０５）；注射组各时间点ＢＣＶＡ、ＲＮＶ消退情况均显著优于对照组（均为Ｐ＜０．０５）。注射组各时间点黄斑中心凹视网膜厚度均较治疗前显著下降（均为Ｐ＜０．０５），对照组各时间点黄斑中心凹视网膜厚度均较治疗前显著降低（均为Ｐ＜０．０５），两组之间各时间点比较，差异均无统计学意义（均为Ｐ＞０．０５）。结论　ＰＲＰ能延迟单纯ＩＶＢ后ＲＮＶ的复发；联合治疗可更有效地推动ＰＤＲ中ＲＮＶ消退，安全可靠，可以更好地保护患者的视觉功能。
Abstract:
Objective To assess fade effects of bevacizumab injections in vitreous ( IVB ) on retinal neovascularization ( RNV) of proliferative diabetic retinopathy ( PDR) , and evaluate the clinical efficacy and safety of IVB combined with panretinal photocoagulation ( PRP) on PDR. Methods Seventy-two PDR patients (72 eyes) underwent PRP were collected, and divided into injection group and control group. Injection group was completed IVB l. 25 mg, then 7 days later FFA examination was performed . and PRP was given at the first quadrant . I time one week for 4 times ; Control group was given PRP , I time one week for 4 times. BCVA , IOP , FFA , OCT . front section and fundus were reviewed in two groups at 4 weeks ,8 weeks , 12 weeks after PRP. Results At I week after IVB in the injection group , BCVA was improved,the leakage area was decreased, there was statistical difference compared with pre-operation (P < 0. 05 ) . BCVA and fade effects in the injection group at different time points were better than those in the control group ( all P < 0. 05 ) . The central macular thickness at each time point after treatment in the injection group and control group were lower than that before treatment ( all P < 0. 05 ) , but there was no statistical difference between two groups ( all P > 0. 05 ) . Conclusion IVB can promote the RNV fade in a short time . reduce the RNV leakage and improve eyesight , and protect the patient ’ s visual function effectively.

相似文献/References:

[1]麻南 李丹 高付林 胡莲娜.玻璃体内注射贝伐单抗和贝伐单抗/曲安奈德联合用药治疗糖尿病性黄斑水肿疗效及安全性差异的荟萃分析[J].眼科新进展,2012,32(6):000.
[2]衡欣 陈悦.增生型糖尿病视网膜病变患者血清中转化生长因子-β1和结缔组织生长因子水平的变化及意义[J].眼科新进展,2013,33(4):000.
[3]刘祎,沙翔垠,彭娟,等. Avastin对翼状胬肉成纤维细胞增殖的影响[J].眼科新进展,2014,34(9):813.[doi:10.13389/j.cnki.rao.2014.0225]
[4]储三军,王敏,徐海峰.贝伐单抗对人脐静脉内皮细胞纤维化相关炎症因子表达的影响[J].眼科新进展,2015,35(11):1025.[doi:10.13389/j.cnki.rao.2015.0280]
　CHU San-Jun,WANG Min,XU Hai-Feng.Effects of bevacizumab on expression of fibrosis-related inflammatory mediators in human umbilical vein endothelial cells[J].Recent Advances in Ophthalmology,2015,35(10):1025.[doi:10.13389/j.cnki.rao.2015.0280]
[5]赵新荣,杨炜,邱明磊,等.玻璃体内注射雷珠单抗联合玻璃体切割术治疗严重增生型糖尿病视网膜病变[J].眼科新进展,2015,35(11):1064.[doi:10.13389/j.cnki.rao.2015.0291]
　ZHAO Xin-Rong,YANG Wei,QIU Ming-Lei,et al.Ranibizumab injection and vitrectomy for severe proliferative diabetic retinopathy[J].Recent Advances in Ophthalmology,2015,35(10):1064.[doi:10.13389/j.cnki.rao.2015.0291]
[6]刘建伟,李聪伶,于海群.雷珠单抗玻璃体内注射对增生型糖尿病视网膜病变玻璃体切割术效果的影响[J].眼科新进展,2016,36(3):265.[doi:10.13389/j.cnki.rao.2016.0071]
　LIU Jian-Wei,LI Cong-Ling,YU Hai-Qun.Effects of intravitreal injection of ranibizumab on vitrectomy for proliferative diabetic retinopathy[J].Recent Advances in Ophthalmology,2016,36(10):265.[doi:10.13389/j.cnki.rao.2016.0071]
[7]饶玉萍,徐玲娟,肖紫云,等.增生型糖尿病视网膜病变患者血浆和玻璃体中VEGF和低密度脂蛋白受体相关蛋白6的表达及其相关性[J].眼科新进展,2016,36(3):278.[doi:10.13389/j.cnki.rao.2016.0075]
　RAO Yu-Ping,XU Ling-Juan,XIAO Zi-Yun,et al.Expression and correlation of LRP6 and VEGF in plasma and vitreous of PDR patients[J].Recent Advances in Ophthalmology,2016,36(10):278.[doi:10.13389/j.cnki.rao.2016.0075]
[8]韩治华,杨淑焕,郭卫民,等.TGF-β介导的Smad信号通路在增生型糖尿病视网膜病变中的作用和意义[J].眼科新进展,2016,36(10):957.[doi:10.13389/j.cnki.rao.2016.0256]
　HAN Zhi-Hua,YANG Shu-Huan,GUO Wei-Min,et al.Role and significance of TGF-β mediated Smad signaling pathways in proliferative diabetic retinopathy[J].Recent Advances in Ophthalmology,2016,36(10):957.[doi:10.13389/j.cnki.rao.2016.0256]
[9]石兴东,李文博,马腾,等.玻璃体切割手术治疗增生型糖尿病视网膜病变的疗效观察[J].眼科新进展,2017,37(3):248.[doi:10.13389/j.cnki.rao.2017.0062]
　SHI Xing-Dong,LI Wen-Bo,MA Teng,et al.Effects of vitrectomy on proliferative diabetic retinopathy[J].Recent Advances in Ophthalmology,2017,37(10):248.[doi:10.13389/j.cnki.rao.2017.0062]
[10]张照华,杨玲玲,张盼盼,等.贝伐单抗对视网膜色素上皮细胞抗氧化功能的影响[J].眼科新进展,2017,37(4):305.[doi:10.13389/j.cnki.rao.2017.0077]
　ZHANG Zhao-Hua,YANG Ling-Ling,ZHANG Pan-Pan,et al.Effects of bevacizumab on antioxidative function in human retinal pigment epithelial cells[J].Recent Advances in Ophthalmology,2017,37(10):305.[doi:10.13389/j.cnki.rao.2017.0077]
[11]丁国龙,谢安明,雷剑琴,等.增生型糖尿病视网膜病变患者玻璃体内注射贝伐单抗后房水中细胞因子的变化及其相关性分析[J].眼科新进展,2017,37(4):358.[doi:10.13389/j.cnki.rao.2017.0091]
　DING Guo-Long,XIE An-Ming,LEI Jian-Qin,et al.Changes of cytokines in aqueous humor of patients with proliferative diabetic retinopathy after intravitreal bevacizumab and their correlation analysis[J].Recent Advances in Ophthalmology,2017,37(10):358.[doi:10.13389/j.cnki.rao.2017.0091]

更新日期/Last Update: 2016-10-25