摘要
目的探讨玻璃体腔注射雷珠单抗联合小梁切除术对新生血管性青光眼患者眼压的影响。方法选取2015年7月至2018年1月盘锦辽油宝石花医院眼科收治的68例新生血管性青光眼患者作为研究对象,按照治疗方案不同将患者分为观察组(38例)与对照组(30例)。观察组使用玻璃体腔注射雷珠单抗+广泛视网膜光凝术+小梁切除术治疗,对照组采用广泛视网膜光凝术+睫状体光凝术。对患者治疗前以及治疗后7 d、90 d、180 d眼压进行监测,比较两组患者治疗前后眼压变化、虹膜新生血管消退时间和随诊180 d复发情况。结果治疗前、治疗后7 d,两组患者眼压比较,差异无统计学意义(P>0.05);治疗90 d和180 d,观察组患者眼压均明显低于对照组,差异有统计学意义(P<0.05)。观察组患者的虹膜新生血管在行注射雷珠单抗后3 d即全部消失,对照组26.7%(8/30)患者的虹膜新生血管在广泛性视网膜激光光凝后仅部分消退,在睫状体光凝术后才全部消退。术后180 d对照组有23.3%(7/30)的患者复发虹膜新生血管,观察组患者的复发率仅为5.3%(2/38),差异有统计学意义(P<0.05)。结论使用玻璃体腔注射雷珠单抗联合小梁切除术治疗新生血管性青光眼能更早消退虹膜新生血管,有效而持久地降低眼压,效果显著。
Objectiv To explore the effects of Intravitreal Injection of Leizhumab combined with Trabeculectomy on intraocular pressure(IOP) in patients with neovascular glaucoma. Method From July 2015 to January 2018, 68 patients with neovascular glaucoma admitted to the Department of Ophthalmology of Panjin Liaoyou Baoshi Hospital, were selected as research objects. According to different treatment schemes, the patients were divided into observation group(38 cases) and control group(30 cases). The observation group was treated by Intravitreal Injection of Leizhumab + extensive retinal photocoagulation + trabeculectomy, while the control group was treated by extensive retinal photocoagulation + ciliary photocoagulation. Intraocular pressure was monitored before and 7, 90 and 180 days after treatment. The changes of intraocular pressure, the time of iris neovascularization regression and the recurrence after 180 days follow-up were compared between the 2 groups. Results 7 days before and after treatment, there was no significant difference in IOP between the 2 groups(P>0.05);90 days and 180 days after treatment, the IOP in the observation group was significantly lower than that in the control group(P<0.05). The iris neovascularization of the patients in the observation group disappeared 3 days after the injection of leizumab.In the control group, 26.7%(8/30) of patients with iris neovascularization only partially subsided after extensive retinal laser photocoagulation, and only completely subsided after ciliary body photocoagulation. 180 d after surgery, 23.3%(7/30) of patients in the control group had recurrent iris neovascularization. The recurrence rate in the observation group was only 5.3%(P<0.05). Conclusion The treatment of neovascular glaucoma with Intravitreal Injection of Leizumab combined with trabeculectomy can resolve the iris neovascularization earlier, effectively reduce of intraocular pressure for a long time, with satisfactory results.
作者
赵越
ZHAO Yue(Department of Ophthalmology,Panjin Liaoyou Baoshi Hospital,Panjin 124010,China)
出处
《中国药物经济学》
2019年第12期76-78,82,共4页
China Journal of Pharmaceutical Economics
