玻璃体腔注射雷珠单抗或联合曲安奈德治疗糖尿病视网膜病变-ME的对比研究

Comparative Study of Intravitreal Ranibizumab or It Combined with Triamcinolone Acetonide for the Treatment of Diabetic Retinopathy-ME

目的比较玻璃体腔注射雷珠单抗、玻璃体腔注射雷珠单抗联合曲安奈德治疗糖尿病视网膜病变-黄斑水肿(macular edema,ME)的临床疗效。方法于2016年1月—2017年3月期间选取该院及合作单位收治的60例糖尿病视网膜病变伴黄斑水肿患者随机分为单一组、联合组,每组30例,单一组采用玻璃体腔注射雷珠单抗治疗,联合组采用玻璃体腔注射雷珠单抗联合曲安奈德治疗,比较两组黄斑水肿减轻总有效率、黄斑水肿厚度、中央视网膜厚度、最佳矫正视力(BCVA)、眼压、并发症发生率。结果联合组的黄斑水肿减轻总有效率(93.33%)明显高于单一组(P<0.05);治疗后,联合组患者的黄斑水肿厚度(192.58±61.92)μm、中央视网膜厚度(152.54±99.87)μm、眼压(13.02±4.39)mm Hg均低于单一组(P<0.05),其BCVA(10.53±3.29)高于单一组(P<0.05);联合组、单一组的并发症发生率分别为6.67%、3.33%,比较差异无统计学意义(P>0.05)。结论采用雷珠单抗与曲安奈德联合玻璃体腔注射治疗糖尿病视网膜病变伴黄斑水肿,疗效显著,且安全性可靠。

Objective This paper tries to compare the clinical curative effect of intravi treal ranibizumab, and intravitreal ranibizumab combined with triamcinolone acetonide in the treatment of diabet ic retinopathy and macular edema （ME）. Methods 60 cases of diabetes patients with retinopathy macular edema from January 2016 to March 2017 in this hospital were selected and randomly divided into the single group and the combined group, with 30 cases in each group, the single group received intravi treal ranibizumab treatment, the combined group received intravi treal ranibizum- ab and triamcinolone acetonide therapy, and then the total efficiency of macular edema relief, the thickness of macular edema and central retinal , best corrected visual acuity （BCVA）, intraocular pressure and the incidence of complications were compared. Results The total efficiency of macular edema re l ief of the combined group was 93 .3 3%, significantly higher than that of the single group （P〈0.05）; after treatment, the thickness of macular edema was （192.58±61.92）μ m, central retinal thickness was （152.54±99.87）μ m, intraocular pressure was （13.02±4.39）mmHg in combined group, lower than those in the single group （P〈0.05）, the BCVA was （10.53±3.29）, higher than that of the single group （P〈0.05）; the incidence of complications in combined group and the single group was 6.67% and 3.33% respectively, there was no significant difference（P〉0.05）. Conclusion The combined of intravitreal ranibizumab with triamcinolone acetonide for patients with diabet ic retinopathy is of significant and safe curative effect.