不同剂量康柏西普玻璃体腔注射治疗早产儿视网膜病变的效果及对血清血管内皮生长因子的影响

Effect of intravitreal injection of different doses of conbercept in the treantment of retinopathy of prematurity and its effect on serum vascular endothelial growth factor

目的研究玻璃体腔内注射不同剂量康柏西普治疗早产儿视网膜病变(ROP)的效果及其对患儿血清血管内皮生长因子(VEGF)的影响。方法将2020年7月至2022年7月赣州市人民医院诊断为早产儿视网膜病变的17例(28眼)患儿纳入研究,采取随机数表法分为A组和B组,其中A组8例13眼,康柏西普剂量为0.25 mg/0.025 mL,B组9例15眼,康柏西普剂量为0.15 mg/0.015 mL。比较两组患者一次玻璃体注射康柏西普眼用注射治疗ROP的效果,以及治疗前、治疗后7 d的血清VEGF及内皮素-1(ET-1)水平,治疗前、治疗后1个月的神经行为评分、感觉统合能力评分及适应行为能力评分的变化,同时比较两组患者治疗前后眼压变化及其他并发症发生情况。结果A组、B组ROP的治疗总有效率分别为100.00%、93.33%,差异无统计学意义(P>0.05);治疗后第7天,两组患儿的血清VEGF和血清ET-1水平明显低于治疗前,差异均有统计学意义(P<0.05),但组间比较差异均无统计学意义(P>0.05);治疗后1个月,两组患儿的神经行为、感觉统合能力及适应行为能力评分明显高于治疗前,差异均有统计学意义(P<0.05),但组间比较差异均无统计学意义(P>0.05);两组患儿注射治疗后5 min、30 min眼压均较术前增高,且B组眼压较A组增幅更小,术后组间比较差异有统计学意义(P<0.05);A组、B组患儿的并发症发生率分别为0、6.67%,差异无统计学意义(P>0.05)。结论应用0.15 mg/0.015 mL或0.25 mg/0.025 mL康柏西普开展玻璃体腔注射治疗,均可发挥良好的疗效,但0.15 mg/0.015 mL康柏西普对短期时间内眼压的影响小。

Objective To investigate the effect of intravitreal injection of different doses of conbercept in the treatment of retinopathy of prematurity(ROP)and its effect on serum vascular endothelial growth factor(VEGF).Methods A total of 17 cases(28 eyes)diagnosed with retinopathy of prematurity in Ganzhou People's Hospital from July 2020 to July 2022 were included.The patients were divided into group A and group B by random number table method.Eight cases(13 eyes)in group A were treated with conbercept dose of 0.25 mg/0.025 mL,and 9 cases(15 eyes)in group B were treated with conbercept at a dose of 0.15 mg/0.015 mL.The effect of one-time intravitreal injection of conbercept in the treatment of ROP were compared between the two groups.The levels of serum VEGF and endothelin-1(ET-1)before and at 7 days after treatment,and the changes of neurobehavioral score,sensory integration ability score,and adaptive behavior ability score before and at 1 month after treatment were compared.The changes of intraocular pressure and other complications were compared between the two groups before and after treatment.Results The total effective rates of ROP in group A and group B were 100.00%and 93.33%,respectively,with no statistically significant differences(P>0.05).On the 7 th day after treatment,the levels of serum VEGF and serum endothelin-1 in the two groups were significantly lower than those before treatment(P<0.05),but there was no significant difference between the two groups(P>0.05).One month after treatment,the scores of neurobehavioral,sensory integration ability,and adaptive behavior ability of children in the two groups were significantly higher than those before treatment(P<0.05),but there was no significant difference between the two groups(P>0.05).The intraocular pressure at 5 min and 30 min after injection in the two groups was higher than that before operation,and the increase in group B was smaller than that in group A,with statistically significant differences(P<0.05).The incidence of complications in group A and group B was 0 and 6.67%,respectively,and the difference was not statistically significant(P>0.05).Conclusion Intravitreal injection of 0.15 mg/0.015 mL or 0.25 mg/0.025 mL of conbercept both have a good effect,but 0.15 mg/0.015 mL of conbercept has little effect on intraocular pressure in the short term.