阿托伐他汀联合雷珠单抗治疗高血脂糖尿病性黄斑水肿

Intravitreal Ranibizumab injection combined with Atorvastatin in the treatment of hyperlipidemic diabetic macular edema

目的观察口服阿托伐他汀联合玻璃体内注射雷珠单抗治疗高血脂糖尿病性黄斑水肿(DME)的临床疗效。方法本研究采用前瞻性随机对照的临床病例分析。纳入2014年1月至2016年10月间确诊的伴有高血脂的DME 40例(40眼)。患者随机分为治疗组和对照组,每组20例。对照组玻璃体内注射雷珠单抗,每月1次,连续3个月;治疗组,在对照组治疗基础上联合口服阿托伐他汀,每日1次,每次10 mg,疗程3个月。评价两组疗效。结果两组患者治疗后1、3、6个月的BCVA及黄斑中心凹厚度(CMT)均较术前改善,差异有统计学意义(P<0.05)。治疗后BCVA两组间差异无统计学意义(P>0.05)。治疗后6个月两组间CMT比较差异有统计学意义(P=0.049)。治疗后6个月治疗组硬性渗出减少率70%,对照组减少25%,两组间差异有统计学意义(P=0.004)。结论口服阿托伐他汀联合玻璃体注射雷珠单抗可以有效治疗高血脂糖尿病性黄斑水肿,改善视力,并促进硬性渗出的吸收。

Objective To observe the clinical efficacy of intravitreal injection of Ranibizumab combined with oral Atorvastatin in the treatment of hyperlipidemic diabetic macular edema (DME). Methods The data of 40 eyes of 40 patients with hyperlipidemic DME were analyzed retrospectively.All cases were randomly divided into treatment group and control group,in 20 eyes each group.The control group was treated with intravitreal injection of Ranibizumab,1time per month for 3months.The treatment group was treated with intravitreal injection of Ranibizumab combined with oral Atorvastatin,1time a day, each time 10mg,for 3 months.The efficacy was evaluated between the two groups.Results The BCVA and central macular retinal thickness (CMT)of the two groups were significantly improved at 1,3 and 6 months after treatment(P <0.05).The difference in BCVA was not statistically significant between the two groups (P >0.05).The difference of CMT was statistically significant between the two groups at 6 months after treatment (P =0.049).The hard exudates reducing rate was 70.00%in treatment group at 6 months after treatment and 25.00%in control group.The difference was statistically significant (P =0.004). Conclusion Intravitreal injection of Ranibizumab combined with oral Atorvastatin can effectively reduce the leakage of retina and macular edema,improve visual acuity and promote the absorption of hard exudates.