雷珠单抗和傲迪适对黄斑区微血管结构的影响

赵剑; 谢九冰; 赵连凯

doi:10.12259/j.issn.2095-610X.S20220930

雷珠单抗和傲迪适对黄斑区微血管结构的影响

doi: 10.12259/j.issn.2095-610X.S20220930

1.
沈阳爱尔眼视光医院眼底病科，辽宁沈阳　110003
2.
唐山市眼科医院，河北唐山　063000
3.
丹东市第一医院眼科，辽宁丹东　118000

基金项目: 河北省医学科学研究计划基金资助项目（20201549）

详细信息

作者简介:
赵剑（1981～），男，辽宁沈阳人，医学学士，副主任医师，主要从事眼底病临床诊疗工作

中图分类号: R774.5；R587.1
计量
- 文章访问数: 2066
- HTML全文浏览量: 1814
- PDF下载量: 11
- 被引次数: 0
出版历程
- 收稿日期: 2022-06-27
- 网络出版日期: 2022-09-08
- 刊出日期: 2022-09-29

Effects of Ranibizumab and Odix on the Microvascular Structure of the Macular Region

1.
Fundus Disease Department of Shenyang Aier Optometry Hospital，Shenyang Liaoning 110003
2.
Tangshan Eye Hospital，Tangshan Hebei 063000
3.
Dept. of Ophthalmology，The 1st Hospital of Dandong，Dandong Liaoning 118000，China

摘要

摘要: 目的探讨雷珠单抗和傲迪适对视网膜静脉阻塞-黄斑水肿（RVO-ME）患者黄斑区微血管结构的影响。方法将眼科收治并确诊的RVO-ME所有患者纳入筛选范围，选取101例患者作为研究对象，纳入时间2020年1月至2021年12月，按治疗方法差异将其分成A、B组（观察组、对照组），各51例、50例，A组给予玻璃体腔注射雷珠单抗治疗，B组给予玻璃体腔注射傲迪适治疗，将2组年龄、性别及治疗前后的最佳矫正视力（BCVA）、黄斑中心凹厚度（CMT）及视网膜浅层毛细血管层（SCP）、深层毛细血管层血流密度（DCP）及其他治疗有效率等指标纳入SPSS21.0软件处理，比较其治疗治疗差异。结果（1）A、B组治疗前BCVA、CMT、SCP、DCP相比差异无统计学意义（P > 0.05），随着治疗时间的后延，A、B组的BCVA、CMT、SCP、DCP均显著改善，且B组较A组更优，差异有统计学意义（P < 0.05）；（2）A组治疗后3、6个月时治疗总有效率各94.12%、98.04%，B组各84.00%、88.00%，且B组较A组更优，差异有统计学意义（P < 0.05）。结论傲迪适治疗能有效的改善RVO-ME患者的黄斑区微血管结构。
- 雷珠单抗 /
- 傲迪适 /
- 视网膜静脉阻塞 /
- 黄斑水肿 /
- 黄斑区微血管结构
Abstract: Objective To investigate the effect of ranibizumab and odix on the microvascular structure of the macular region in patients with retinal vein occlusion-macular edema （RVO-ME）. Methods All patients with RVO-ME admitted and diagnosed in the ophthalmology department of our hospital were included in the screening scope, and 101 of them were selected as the research subjects. The inclusion time was from January 2020 to December 2021, and they were divided into the observation group and the control group according to the differences in treatment methods, with 51 cases and 50 cases in each group. The observation group was given intravitreal injection of ranibizumab, and the control group was given intravitreal injection of AODEX. The age, gender, best corrected visual acuity （BCVA）, macular fovea thickness （CMT）, shallow retinal capillary layer （SCP）, deep capillary layer blood flow density （DCP） and other effective rates of the two groups before and after the treatment were included in spss21.0 software to compare the treatment differences. Results （1） There was no significant difference in BCVA, CMT, SCP, and DCP between the two groups before the treatment （P > 0.05）. With the delay of treatment time, BCVA, CMT, SCP and DCP of the two groups were significantly improved ,the control group was better than the observation group and the difference was statistically significant （P < 0.05） and （2） The total effective rates of the observation group were 94.12% and 98.04% at 3 and 6 months after the treatment while the total effective rates of the control group were 84.00% and 88.00%, showing that the control group was better than the observation group and the difference was statistically significant （P < 0.05）. Conclusion Autodix treatment can effectively improve the macular microvascular structure in RVO-ME patients.
- Ranibizumab /
- AODIX /
- Retinal vein occlusion /
- Macular edema /
- Microvascular structure of macular region

HTML全文

图 1 黄斑区视网膜内病灶呈高反射

Figure 1. Intraretinal lesions in the macular region are highly reflective

下载: 全尺寸图片幻灯片

图 2 治疗后左眼黄斑区见脉络膜新生血管信号（圆圈）

A：治疗前脉络膜新生血管呈现高反射物质信号；B：治疗中脉络膜新生血管信号情况；C：治疗后脉络膜新生血管信号减弱，高反射物质信号转为低平。

Figure 2. Choroidal neovascularization signal （circle） in the macular area of the left eye after treatment

下载: 全尺寸图片幻灯片

表 1 A、B组常规资料统计情况表[$\bar x \pm s $/n（%）]

Table 1. Statistics of routine data of groups A and B [$\bar x \pm s $/n]

组别	年龄区间（岁）	平均年龄（岁）	性别		患眼眼数（n）
组别	年龄区间（岁）	平均年龄（岁）	男	女	患眼眼数（n）
A组	44～70	60.52 ± 5.78	31	20	51
B组	45～70	60.23 ± 5.56	29	21	50
χ²/t		0.257	0.081
P		< 0.001^*	< 0.001^*
^*P < 0.05。

下载: 导出CSV

表 2 A、B组治疗前后的BCVA差异比较[（$ \bar x \pm s $），μm]

Table 2. Comparison of BCVA differences between groups A and B before and after treatment [（$ \bar x \pm s $），μm]

组别	n	治疗前	治疗后
组别	n	治疗前	1 d	3个月	6个月
A组	51	1.09 ± 0.43	0.76 ± 0.47	0.67 ± 0.24^*	0.58 ± 0.13^*
B组	50	1.12 ± 0.41	0.82 ± 0.35	0.51 ± 0.19	0.41 ± 0.21
t		0.359	−0.729	3.719	4.902
P		0.720	0.468	< 0.001^*	< 0.001^*
^*P < 0.05。

下载: 导出CSV

表 3 A、B组治疗前后的CMT差异比较[（$ \bar x \pm s $），μm]

Table 3. Comparison of CMT differences between groups A and B before and after treatment [（$ \bar x \pm s $），μm]

组别	n	治疗前	治疗后
组别	n	治疗前	1 d	3个月	6个月
A组	51	470.35 ± 113.54	425.76 ± 100.47	376.67 ± 103.24^*	342.14 ± 112.31^*
B组	50	472.32 ± 101.37	400.82 ± 102.36	320.51 ± 101.19	297.14 ± 106.52
t		0.092	1.236	2.861	2.078
P		0.927	0.219	0.007^*	0.038^*
^*P < 0.05。

下载: 导出CSV

表 4 A、B组治疗前后的SCP差异比较[（$ \bar x \pm s $），%]

Table 4. Comparison of SCP differences between groups A and B before and after treatment[（$ \bar x \pm s $），%]

组别	n	治疗前	治疗后
组别	n	治疗前	1 d	3个月	6个月
A组	51	51.09 ± 11.43	43.76 ± 8.47	46.67 ± 6.24^*	54.58 ± 4.13^*
B组	50	40.12 ± 10.41	45.82 ± 8.35	52.51 ± 5.86	61.41 ± 4.26
t		0.014	−1.231	−4.849	−8.298
P		0.989	0.221	< 0.001^*	< 0.001^*
^*P < 0.05。

下载: 导出CSV

表 5 A、B组治疗前后的DCP差异比较[（$ \bar x \pm s $），%]

Table 5. Comparison of DCP differences between groups A and B before and after treatment [（$ \bar x \pm s $），%]

组别	n	治疗前	治疗后
组别	n	治疗前	1 d	3个月	6个月
A组	51	41.09 ± 8.47	43.76 ± 6.47^*	48.67 ± 7.24^*	53.58 ± 8.13^*
B组	50	40.12 ± 8.43	46.82 ± 7.35	54.51 ± 7.19	62.34 ± 8.21
t		0.577	−2.219	−4.067	−5.387
P		0.565	0.029*	< 0.001^*	< 0.001^*
^*P < 0.05。

下载: 导出CSV

表 6 A、B组治疗前后的SRF差异比较[（$ \bar x \pm s $），μm]

Table 6. Comparison of SRF differences between groups A and B before and after treatment[（$ \bar x \pm s $），μm]

组别	n	治疗前	治疗后
组别	n	治疗前	1 d	3个月	6个月
A组	51	211.09 ± 38.46	188.46 ± 41.35^*	148.64 ± 31.65^*	43.64 ± 8.48^*
B组	50	210.46 ± 35.33	171.82 ± 37.75	124.51 ± 27.19	28.53 ± 6.73
t		0.085	2.112	4.113	9.929
P		0.576	0.037	< 0.001^*	< 0.001^*
^*P < 0.05。

下载: 导出CSV

参考文献(16)

[1]	Bandah-Rozenfeld D,Littink K W,Ben-Yosef T,et al. Novel null mutations in the EYS gene are a frequent cause of autosomal recessive retinitis pigmentosa in the Israeli population[J]. Investigative Ophthalmology & Visual Science,2010,51(9):4387-4394.
[2]	Quinn P M,Mulder A A,Alves C H,et al. Loss of CRB2 in Müller glial cells modifies a CRB1-associated retinitis pigmentosa phenotype into a Leber congenital amaurosis phenotype[J]. Human Molecular Genetics,2019,28(1):105-123. doi: 10.1093/hmg/ddy337
[3]	Garweg JG,Zandi S. Retinal vein occlusion and the use of a dexamethasone intravitreal implant (Ozurdex®) in its treatment[J]. Graefes Arch Clin Exp Ophthalmol,2016,254(7):1257-65. doi: 10.1007/s00417-016-3350-x
[4]	Rosenblatt A,Udaondo P,Cunha-Vaz J,et al. A collaborative retrospective study on the efficacy and safety of intravitreal dexamethasone implant (Ozurdex) in patients with diabetic macular edema:The European DME registry study[J]. Ophthalmology,2020,127(3):377-393. doi: 10.1016/j.ophtha.2019.10.005
[5]	Talib M,Cauwenbergh C V,Zaeytijd J D,et al. CRB1-associated retinal dystrophies in a Belgian cohort:Genetic characteristics and long-term clinical follow-up[J]. Br J Ophthalmol,2022,106(5):696-704. doi: 10.1136/bjophthalmol-2020-316781
[6]	Yeen-Fey H,Chao A,Chen K J,et al. Clinical outcomes and predictors of response to photodynamic therapy in symptomatic circumscribed choroidal hemangioma:A retrospective case series[J]. PLoS ONE,2018,13(5):e0197088. doi: 10.1371/journal.pone.0197088
[7]	郭丽莉,程湧,邓洵,等. 激光视网膜光凝与抗VEGF疗法治疗I型ROP后远期黄斑区形态比较及其对视力预后的影响[J]. 中华实验眼科杂志,2022,40(1):47-53.
[8]	Salerno F R,Alireza A,Sandrine L,et al. Outcomes and predictors of skin sodium concentration in dialysis patients[J]. Clin Kidney J,2022,15(6):1129-1136. doi: 10.1093/ckj/sfac021
[9]	Satoshi E,Koji O,Kosuke K,et al. Predictors of Rituximab Effect on Modified Rodnan Skin Score in Systemic Sclerosis:a machine learning analysis of the DESIRES trial[J]. Rheumatology(Oxford),2020,15(7):171-173.
[10]	鞠晓妮. 眼底激光联合雷珠单抗对糖尿病性视网膜病变患者视力及并发症的影响[J]. 当代医学,2021,27(10):182-183. doi: 10.3969/j.issn.1009-4393.2021.10.077
[11]	Van der Wijk AE,Canning P,Van Heijningen RP,et al. Glucocorticoids exert differential effects on the endothelium in an in vitro model of the blood-retinal barrier[J]. Acta Ophthalmol,2019,97(2):214-224. doi: 10.1111/aos.13909
[12]	郭建新,韩佳欣,李明新,等. 糖尿病视网膜病变患者泪膜脂质层厚度与黄斑微血管改变的相关性[J]. 国际眼科杂志,2020,20(3):449-454.
[13]	彭立,张小花,劳娜,等. 康柏西普与雷珠单抗治疗视网膜静脉阻塞继发黄斑水肿的Meta分析[J]. 国际眼科杂志,2020,20(3):455-463.
[14]	陈敏华,张小花,谢青,等. 地塞米松玻璃体内植入剂对比雷珠单抗治疗糖尿病黄斑水肿的疗效及安全性的荟萃分析[J]. 临床与病理杂志,2021,41(3):615-622.
[15]	刘俐娜,钟兴武,刘红山,等. 雷珠单抗或加减驻景方对形觉剥夺性近视豚鼠眼轴和脉络膜厚度的短期影响[J]. 国际眼科杂志,2020,3(4):599-602. doi: 10.3980/j.issn.1672-5123.2020.4.04
[16]	季红英,杨林青,郭黎霞,等. 视网膜激光联合球内注射雷珠单抗治疗视网膜静脉阻塞黄斑水肿对黄斑区微血管结构变化的影响[J]. 中国医师杂志,2021,23(10):1555-1558.

相关文章(20)

[1]	杨东艳, 林华, 张宇箫, 赵昆颖, 向丽蓉, 杨淑达, 胡炜彦. 贝伐珠单抗联合替莫唑胺用于复发性高级别脑胶质瘤的有效性及安全性分析, 昆明医科大学学报. doi: 10.12259/j.issn.2095-610X.S20240410
[2]	罗娅, 余彦廷, 张雪, 王重娟. 托珠单抗治疗COVID-19导致继发感染风险的Meta分析, 昆明医科大学学报. doi: 10.12259/j.issn.2095-610X.S20240208
[3]	宋文娟, 马雪娟, 孙钺, 谷颖, 叶雨佳, 李姝墨, 葛菲, 刘利萍, 赵月, 王钰. 超声心动图三维斑点追踪技术对乳腺癌曲妥珠单抗治疗中心脏毒性评估的应用, 昆明医科大学学报. doi: 10.12259/j.issn.2095-610X.S20230217
[4]	吴斯琪, 陈刚, 肖亦爽. 急进型早产儿视网膜病变的治疗效果, 昆明医科大学学报. doi: 10.12259/j.issn.2095-610X.S20220513
[5]	李剑萍, 高学仁, 张晓艳, 陈平, 陈苏蓉, 卞伟钢, 黄志军. 卡培他滨联合贝伐珠单抗或卡培他滨单药在晚期结直肠癌维持治疗中的疗效与安全性, 昆明医科大学学报. doi: 10.12259/j.issn.2095-610X.S20210908
[6]	刘丽, 肖丽波, 徐文荣, 刘晓晨, 赵联玖. 内界膜剥除术治疗特发性黄斑裂孔的临床疗效, 昆明医科大学学报.
[7]	李丽萍, 赵洪超, 张云珠, 李俊. 抗VEGF治疗视网膜静脉阻塞伴黄斑水肿患者疗效及预后影响因素, 昆明医科大学学报.
[8]	边海霞. 糖尿病视网膜病变脂肪因子与血管病变相关因子关系的研究, 昆明医科大学学报.
[9]	杨林红. 眼内注射康柏西普治疗视网膜分支静脉阻塞继发黄斑水肿的临床观察, 昆明医科大学学报.
[10]	杨明. 一种优化的大鼠视网膜组织石蜡切片制作方法, 昆明医科大学学报.
[11]	唐茂丹. CNPase在新生大鼠视网膜发育过程中的表达, 昆明医科大学学报.
[12]	陈贤玉. 曲妥珠单抗1治疗HER-2过表达乳腺癌的研究进展, 昆明医科大学学报.
[13]	马珊. 凉血活血药物对氧诱导小鼠视网膜新生血管实验中HIF-1和NF-κB的影响, 昆明医科大学学报.
[14]	. 复方光明胶囊对实验性大鼠视网膜光损伤的作用, 昆明医科大学学报.
[15]	. 糖化血红蛋白与糖尿病视网膜病变的关系研究, 昆明医科大学学报.
[16]	. 高危新生儿视网膜出血490例临床分析报告, 昆明医科大学学报.
[17]	. 复方光明胶囊对SD大鼠视网膜光损伤的疗效观察, 昆明医科大学学报.
[18]	唐茂丹. 大鼠视神经切断后视网膜Muller细胞及小胶质细胞变化特点, 昆明医科大学学报.
[19]	李国栋. 七叶皂甙钠抗大鼠视网膜缺血-再灌注后视网膜细胞凋亡的保护作用, 昆明医科大学学报.
[20]	王鹏. 曲安奈德对家免视网膜的病理组织学的影响, 昆明医科大学学报.