雷珠单抗与康柏西普玻璃体腔注射治疗糖尿病性黄斑水肿的临床疗效及安全性对比

Comparison of Clinical Efficacy and Safety of Ranibizumab and Conbercept Intravitreal Injection in the Treatment of Diabetic Macular Edema

目的探讨雷珠单抗与康柏西普玻璃体腔注射治疗糖尿病性黄斑水肿(DME)的临床疗效与安全性.方法选取2018年1月—2020年1月该院收治的60例DME患者作为研究对象,以随机数表法分为观察组和对照组,每组30例.对照组采用玻璃体腔注射康柏西普治疗,观察组采用玻璃体腔注射雷珠单抗治疗.于治疗前、治疗6个月、治疗12个月,使用标准对数视力表对两组患者进行最佳矫正视力(BCVA)检查,使用眼压计测定两组眼压,对两组患者进行光学相干断层扫描以测定患者黄斑中心凹视网膜厚度(CMT),对两组患者进行荧光素眼底血管造影(FFA)检查以测量患者视网膜新生血管(RNV)渗漏面积,并统计两组并发症发生情况.结果两组治疗前后眼压比较,组间差异无统计学意义(P>0.05).治疗后6、12个月,观察组BCVA均低于对照组,CMT均薄于对照组,RNV渗漏面积均小于对照组,组间差异有统计学意义(P<0.05).两组治疗后均未见眼部并发症及抗VEGF药物相关全身并发症.结论雷珠单抗与康柏西普玻璃体腔注射治疗DME,均可以减轻水肿,降低黄斑厚度,改善视力,减少渗出,应用安全有效,其中前者远期治疗更具临床优势,可作为本病首选治疗药物加以推广使用.

Objective To investigate the clinical efficacy and safety of ranibizumab and conbercept intravitreal injection in the treatment of diabetic macular edema(DME).Methods 60 DME patients admitted to the hospital from January 2018 to January 2020 were selected as the research objects,and divided into an observation group and a control group by random number table method,with 30 cases in each group.The control group was treated with intravitreal injection of conbercept,while the observation group was treated with intravitreal injection of ranibizumab.Before treatment,6 months after treatment,and 12 months after treatment,the best corrected visual acuity(BCVA)examination was performed on the two groups of patients using standard logarithmic visual acuity chart,the intraocular pressure of the two groups was measured using a tonometer,optical coherence tomography was performed on the two groups of patients to determine the patients'central macular thickness(CMT),fluorescein fundus angiography(FFA)was performed on both groups of patients to measure the area of retinal neo-vascularization(RNV)leakage,the incidence of complications in the two groups was counted.Results The intraocular pressure of the two groups before and after treatment was compared,and the differences between the groups were not statistically significant(P>0.05).6 months and 12 months after treatment,the BCVA of the observation group was lower than that of the control group,the CMT was thinner than that of the control group,and the leakage area of RNV was smaller than that of the control group,and the differences between the groups were statistically significant(P<0.05).There were no ocular complications and systemic complications related to anti-VEGF drugs in the two groups after treatment.Conclusion Intravitreal injection of ranibizumab and conbercept in the treatment of DME can reduce edema,reduce macular thickness,improve vision,reduce exudation,the application is safe and effective,and the former has more clinical advantages in long-term treatment,and can be promoted and used as the first-choice treatment drug for this disease.