康柏西普与贝伐单抗玻璃体腔注射治疗新生血管性老年性黄斑变性疗效对比观察

Efficacy of conbercept versus bevacizumab in intramuscular injection for neovascular age-related macular degeneration

目的对比观察康柏西普与贝伐单抗玻璃体腔注射治疗新生血管性老年性黄斑变性疗效。方法回顾性病例研究。临床检查确诊的n AMD患者88例88只眼纳入研究。患者均为首次治疗。其中,男38例38只眼,女50例50只眼;年龄49~61岁,平均年龄(54.65±3.1)岁,均行最佳矫正视力(BCVA)、眼压、眼底彩色照片、FFA、ICGA及光相干断层扫描(OCT)检查。BCVA检查采用国际标准视力表。依据接受治疗情况将患者分为康柏西普治疗组(A组)、贝伐单抗治疗组(B组),分别为46例46只眼,42例42只眼。两组患者年龄(t=-1.45)、性别(X^2=41.26),BCVA(t=-1.59),眼压(t=-1.46),中心视网膜厚度(CRT)(t=-1.67),差异均无统计学意义。对比观察两组患眼治疗后1、3、6、10个月和末次随访BCVA、CRT变化、玻璃体腔注射次数及人均治疗费用。两组患眼治疗后10个月BCVA、CRT与治疗前BCVA、CRT相关性行person、spearman相关分析。结果治疗后1、3、6、10个月,A、B组患眼BCVA与治疗前比较,差异均有统计学意义(t_(A组)=2.15、1.96、2.07、-2.35、2.28,t_(B组)=2.01、2.29、3.01、2.98、2.03,P<0.05)。两组患眼间平均BCVA比较,差异无统计学意义(t=1.31、1.54、0.99、1.48、1.87,P>0.05)。A、B两组患眼CRT与治疗前比较,差异有统计学意义(tA组=2.57、2.49、2.69、2.81、3.23,tB组=2.86、2.63、2.51、3.07、2.74,P<0.05)。两组患眼间平均CRT比较,差异无统计学意义(t=1.37、1.54、0.98、1.298、1.84,P>0.05)。A、B组患眼平均注射次数比较,差异有统计学意义(t=-2.734,P<0.05)。A、B组患眼人均注射费用比较,差异有统计学意义(t=1.57,P<0.05)。所有患者均未出现眼部并发症及全身不良反应。结论与玻璃体腔注射康柏西普比较,玻璃体腔注射贝伐单抗治疗n AMD取得相似的治疗效果,虽然注射次数更多,但总治疗费用明显更少。

Objective To compare the efficacy of intravitreal injection of ambroxol and bevacizumab in the treatment of neovascular age-related macular degeneration. Methods Retrospective case study. 88 patients who were clinically diagnosed as n AMD were enrolled into the study. The patients were the first treated in our study. There were 38 pairs of eyes of 38 males and 50 pairs of eyes of 50 females, aged ranged from 49-61 years old, with mean age(54.65 ± 3.1) years old. All patients were examined with best corrected visual acuity(BCVA), intraocular pressure, fundus color photographs, FFA, ICGA and optical coherence tomography(OCT). BCVA Test was done by the international standard chart. Patients were divided into two groups according to the treatment: convalescent treatment group(group A) with 46 cases 46 eyes and bevacizumab treatment group(group B) with 42 cases 42 eyes. There were no statistical difference of mean age(t =-1.45), gender(X^2= 41.26), BCVA(t =-1.59), IOP(t =-1.46) and central retinal thickness(CRT) between the two groups. The changes in BCVA and CRT, the number of intravitreal injection, and the per capita treatment cost at 1, 3, 6, 10 months and the final follow-up were compared between the two groups. The man and spearman correlation analysis were taken by each group between before-treatment and after10 months treatment in BCVA, CRT. Results After 1, 3, 6 and 10 months treatment, the mean BCVA were improved with statistically in group A(t_A= 2.15, 1.96, 2.07,-2.35, 2.28; P<0.05) and group B(t_B= 2.01, 2.29, 3.01, 2.98, 2.03, P <0.05).There was no significant difference between the two groups in mean BCVA(t = 1.31, 1.54, 0.99, 1.48, 1.87; P> 0.05). Compared with before-treatment, the mean CRT were statistically significant difference in group A(tA= 2.57, 2.49, 2.69, 2.81, 3.23; P<0.05) and group B(tB= 2.86, 2.63, 2.51,3.07, 2.74; P<0.05). There was no significant difference between the two groups in the mean CRT(t = 1.37, 1.54, 0.98, 1.298, 1.84; P>0.05). The average number of injections in group A and B were statistically significant(t =-2.734, P<0.05). The average cost of injection in group A and group B was statistically significant(t = 1.57, P<0.05). There was no systemic or ocular serious side effects during the follow up. Conclusion Comparing with intravitreal injection of Conbercept, vitreous cavity injection of bevacizumab has similar effect on n AMD. Although more injections are need, the total cost of treatment is significantly decreased.