Ozurdex对视网膜静脉阻塞合并黄斑水肿患者房水内VEGF、IL-6及MCP-1水平的影响

Effects of Ozurdex on the levels of VEGF,IL-6 and MCP-1 in aqueous humor of patients with retinal vein occlusion complicated with macular edema

目的探讨地塞米松玻璃体内植入剂(Ozurdex)对视网膜静脉阻塞合并黄斑水肿患者房水内血管内皮生长因子(VEGF)、白细胞介素-6(IL-6)及单核细胞趋化因子蛋白-1(MCP-1)水平的影响。方法前瞻性选取2020年1月至2020年9月在廊坊市第四人民医院就诊的86例视网膜静脉阻塞合并黄斑水肿患者为研究对象,按随机数字表法分为Ozurdex组(43例,43眼)与康柏西普(Conbercept)组(43例,43眼)。Ozurdex组玻璃体腔内注入Ozurdex,Conbercept组玻璃体腔内注入Conbercept。比较两组治疗效果、注射次数、不良反应、复发率,比较两组治疗前后的最佳矫正视力(BCVA)、中央视网膜厚度(CRT)、VEGF、IL-6、MCP-1及视觉相关生存质量表(CVRQoL-25)评分。结果两组总有效率比较,差异无统计学意义(P>0.05)。两组治疗前及治疗后BCVA、CRT比较,差异均无统计学意义(P>0.05);两组治疗后BCVA、CRT较治疗前显著改善,差异均有统计学意义(P<0.05)。两组治疗前及治疗后VEGF、IL-6、MCP-1水平比较,差异均无统计学意义(P>0.05);两组治疗后VEGF、IL-6、MCP-1水平较治疗前显著降低,差异均有统计学意义(P<0.05)。两组治疗前及治疗后CVRQoL-25评分比较,差异均无统计学意义(P>0.05);两组治疗后CVRQoL-25较治疗前显著升高,差异均有统计学意义(P<0.05);Ozurdex组注射次数为(2.10±0.53)次,显著少于Conbercept组[(5.26±1.47)次],差异有统计学意义(P<0.05)。两组不良反应总发生率、复发率比较差异无统计学意义(P>0.05)。结论Conbercept与Ozurdex均可降低视网膜静脉阻塞合并黄斑水肿患者房水内VEGF、IL-6及MCP-1水平,改善黄斑水肿,但与Conbercept相比,Ozurdex注射次数较少。

Objective To investigate the effects of dexamethasone intravitreal implant(Ozurdex)on the levels of vascular endothelial growth factor(VEGF),interleukin-6(IL-6)and monocyte chemokine protein-1(MCP-1)in aqueous humor of patients with retinal vein occlusion complicated with macular edema.Methods From January 2020 to September 2020,86 patients with retinal vein occlusion complicated with macular edema treated in Langfang Fourth People’s Hospital were selected and divided into Ozurdex group(43 cases,43 eyes)and Conbercept group(43 cases,43 eyes)according to the random number table method.Ozurdex and Conbercept were injected intravitreal in Ozurdex group and Conbercept group,respectively.The treatment effect,injection times,adverse reactions and recurrence rate were compared between the two groups.The best corrected visual acuity(BCVA),central retinal thickness(CRT),VEGF,IL-6,MCP-1 and visual related quality of life scale(CVRQoL-25)scores before and after treatment were compared between the two groups.Results There was no statistically significant difference in the total effective rate between the two groups(P>0.05).There was no statistically significant difference in BCVA and CRT between the two groups before and after treatment(P>0.05);after treatment,BCVA and CRT in the two groups were significantly improved compared with those before treatment,the differences were statistically significant(P<0.05).There were no statistically significant differences in VEGF,IL-6 and MCP-1 levels between the two groups before and after treatment(P>0.05);the levels of VEGF,IL-6 and MCP-1 in the two groups after treatment were significantly lower than those before treatment,the differences were statistically significant(P<0.05).There was no statistically significant difference in CVRQoL-25 scores between the two groups before and after treatment(P>0.05);CVRQoL-25 scores in the two groups after treatment were significantly higher than those before treatment,the differences were statistically significant(P<0.05).The number of injections in Ozurdex group were(2.10±0.53)times,which were significantly less than that in Conbercept group[(5.26±1.47)times],the differences were statistically significant(P<0.05).There was no significant difference in the total incidence and recurrence rate of adverse reactions between the two groups(P>0.05).Conclusion Ozurdex and Conbercept can reduce the levels of VEGF,IL-6 and MCP-1 in aqueous humor of patients with retinal vein occlusion complicated with macular edema,and improve macular edema.Compared with Conbercept,Ozurdex can be injected less frequently.