视网膜中央静脉阻塞继发黄斑水肿患者应用雷珠单抗、阿柏西普联合激光光凝术的效果比较

Comparison of the effect of leizumab and arbocept combined with laser pho⁃tocoagulation in patients with central retinal vein occlusion⁃macular edema

目的 比较应用雷珠单抗、阿柏西普联合激光光凝术治疗视网膜中央静脉阻塞继发黄斑水肿(central retinal vein occlusion-macular edema, CRVO-ME)的效果。方法 选择2019年2月~2022年3月本院收治的89例CRVO-ME患者,根据治疗方法不同分为研究组(n=45)与对照组(n=44)。对照组接受雷珠单抗联合激光光凝术治疗,研究组接受阿柏西普联合激光光凝术治疗。2组均治疗3个月,比较2组临床疗效、黄斑中心凹厚度(central macular thickness, CMT)、最佳矫正视力(best corrected visual acuity, BCVA)、炎症因子、黄斑区微血管参数及并发症发生率,随访1年,记录2组注射次数。结果 2组总有效率比较差异无统计学意义(P>0.05)。治疗后,2组BCVA与CMT均降低(P<0.05),2组治疗后BCVA与CMT比较差异无统计学意义(P>0.05)。治疗后,2组可溶性细胞间黏附分子-1(soluble intercellular adhesion molecule-1,sICAM-1)、肿瘤坏死因子α(tumor necrosis factor-α,TNF-α)水平均降低(P<0.05),2组治疗后sICAM-1、TNF-α水平比较差异无统计学意义(P>0.05)。治疗后,2组黄斑中心凹无血管区(foveal avascular zone, FAZ)面积均降低(P<0.05),2组黄斑区视网膜浅层毛细血管网(superficial capillary plexus, SCP)血流密度均升高(P<0.05),2组治疗后FAZ面积、SCP血流密度比较差异无统计学意义(P>0.05)。研究组注射次数低于对照组(P<0.05)。2组总并发症发生率比较差异无统计学意义(P>0.05)。结论 与雷珠单抗联合激光光凝术比较,阿柏西普联合激光光凝术治疗CRVO-ME治疗效果相似,且可减少注射次数。

Objective To compare the efficacy of leizumab and arbocept combined with laser photocoagulation in patients with central retinal vein occlusion-macular edema(CRVO-ME).Methods A total of 89 patients with CRVO-ME admitted to our hospital from February 2019 to March 2022 were selected and divided into research group(n=45)and control group(n=44)according to different treatment methods.The control group was treated with leizumab combined with laser photocoagulation,and the research group was treated with arbocept combined with laser photocoagulation.Both groups were treated for 3 months.The clinical efficacy,central macular thickness(CMT),best corrected visual acuity(BCVA),inflammatory factors,macular microvascular parameters and the incidence of complications were compared between the two groups.The patients were followed up for 1 year,and the injection times of the two groups were recorded.Results There was no difference in total effective rate between the two groups(P>0.05).After treatment,BCVA and CMT were decreased in both groups(P<0.05),and there was no statistical significance in BCVA and CMT between the two groups(P>0.05).After treatment,the levels of soluble intercellular adhesion molecule-1(sICAM-1)and tumor necrosis factorα(TNF-α)were decreased in 2 groups(P<0.05),but there was no statistical significance in the levels of sICAM-1 and TNF-αbetween 2 groups(P>0.05).After treatment,the foveal avascular zone(FAZ)area were decreased in both groups(P<0.05),and the superficial capillary plexus(SCP)blood density were increased in both groups(P<0.05).There were no statistically significant differences in FAZ area and SCP blood density between the two groups after treatment(P>0.05).The injection frequency of the study group was lower than that of the control group(P<0.05).There was no difference in the incidence of total complications between the two groups(P>0.05).Conclusion Compared with leizumab combined with laser photocoagulation,abacept combined with laser photocoagulation in the treatment of CRVO-ME can achieve similar therapeutic effect and reduce injection frequency.