玻璃体内注射雷珠单抗治疗新生血管性年龄相关性黄斑变性的疗效及对患者血清CRP VEGF眼压和视力的影响

Efficacy of Intravitreal Injection of Ranibizumab on Neovascular Age-Related Macular Degeneration and Its Effects on Serum CRP VEGF Intraocular Pressure and Visual Acuity

目的:探究玻璃体内注射雷珠单抗治疗新生血管性年龄相关性黄斑变性(nAMD)的疗效及对患者血清C反应蛋白(CRP)、血管内皮生长因子(VEGF)、眼压和视力的影响。方法:选取我院74例nAMD患者为研究对象,采用随机数字表法通过简单随机分组分为雷珠单抗组及康柏西普组,各37例,两组均经玻璃体内注射治疗。比较两组治疗前、治疗4周、治疗12周时视力[最佳矫正视力(BCVA)]、黄斑中心凹视网膜厚度(CRT)、眼压及血清CRP、VEGF水平差异,以治疗12周时脉络膜新生血管(CNV)渗漏情况评估临床疗效,并记录治疗期间并发症发生情况。结果:两组治疗前后眼压组间及组内比较,差异均无统计学意义(P>0.05);两组组内治疗前后视力、CRT及血清CRP、VEGF比较,均为治疗前>治疗4周>治疗12周(P<0.05);雷珠单抗组治疗4周、12周时CRT及血清CRP、VEGF低于康柏西普组(P<0.05),两组治疗4周、12周时视力比较,差异均无统计学意义(P>0.05)。两组临床疗效和治疗期间并发症发生情况比较,差异均无统计学意义(P>0.05)。结论:在玻璃体内注射治疗nAMD时,康柏西普疗效及安全性可与雷珠单抗相当,但雷珠单抗在改善CRT、降低CRP和VEGF表达方面具有显著优势,临床应用价值高。

Objective To investigate the efficacy of intravitreal injection of Ranibizumab in the treatment of neovascular age-related macular degeneration(nAMD)and its effects on serum C-reactive protein(CRP),vascular endothelial growth factor(VEGF),intraocular pressure and visual acuity of patients.Methods:Seventy-four patients with nAMD in our hospital were selected as the research subjects,and they were categorized as the Ranibizumab group and the Conbercept group with random number table method,with 37 cases in each group.The two groups were treated by intravitreal injection.The visual acuity[best corrected visual acuity(BCVA)],central retinal thickness(CRT),intraocular pressure and levels of serum CRP and VEGF before treatment and 4 weeks and 12 weeks after treatment and choroidal neovascularization(CNV)leakage at 12 weeks after treatment were compared between the two groups,and the clinical efficacy was evaluated,and the occurrence of complications were recorded during treatment.Results:There was no significant difference in intraocular pressure before and after treatment between the groups and within the groups(P>0.05).Comparison of visual acuity,CRT,serum CRP and VEGF before and after treatment in the two groups all showed before treatment>at 4 weeks after treatment>at 12 weeks after treatment(P<0.05).The CRT,serum CRP and VEGF in Ranibizumab group 4 and 12 weeks after treatment were lower than those in Conbercept group(P<0.05).There was no significant difference in visual acuity between the two groups 4 and 12 weeks after treatment(P>0.05).There were no significant differences in clinical efficacy and occurrence of complications during treatment between the two groups(P>0.05).Conclusion:In the case of intravitreal injection for nAMD,the efficacy and safety of Conbercept are comparable to those of Ranibizumab,but Ranibizumab has significant advantages in improving CRT and reducing expressions of CRP and VEGF,and it has high clinical application value.