标题：玻璃体腔注射雷珠单抗联合全视网膜光凝及单纯全视网膜光凝治疗高危增殖性糖尿病视网膜病变的对比研究

      作者：钟志伟，邵东平    南方医科大学附属南海医院眼科，广东 佛山 528000

      卷次： 2019年30卷11期

      【摘要】 目的 比较玻璃体腔注射雷珠单抗联合全视网膜光凝与单纯全视网膜光凝治疗高危增殖性糖尿病视网膜病变(PDR)的效果。方法 选取2016年6月至2018年6月在南方医科大学附属南海医院眼科进行诊疗的高危PDR患者35例(50眼)进行研究。按照随机数表法将患者分为观察组16例24眼和对照组19例26眼。观察组患者采用雷珠单抗联合全视网膜光凝方法治疗，对照组患者单采用全视网膜光凝方法治疗。治疗3个月后，比较两组患者的临床治疗效果、治疗前后中心黄斑厚度、术后最佳矫正视力、激光能量、光斑数以及术后并发症等情况。结果 经治疗，观察组患者的临床总有效率为87.50%，明显高于对照组的61.54%，差异有显著统计学意义(P<0.01)；观察组患者的中心黄斑厚度为(281.4±37.3) μm，明显低于对照组的(344.3±97.1) μm，且激光能量和光斑数分别为(345±13) mW、(1 789±6.4) ms，明显低于对照组的(448±8) mW，(2491±7.1) ms，差异均具有统计学意义(P<0.05)；治疗后观察组患者的最佳矫正视力为0.56± 0.05，明显优于对照组的0.42±0.02，术后并发症的发生率为16.67%，也明显低于对照组的26.92%，差异均具有统计学意义(P<0.05)。结论 玻璃体腔注射雷珠单抗联合全视网膜光凝的治疗方法相比单纯采用全视网膜光凝治疗方法疗效更显著，值得临床上推广应用。
      【关键词】 高危增殖性糖尿病视网膜病变；雷珠单抗；全视网膜激光光凝；疗效；安全性
      【中图分类号】 R587.2 【文献标识码】 A 【文章编号】 1003—6350（2019）11—1401—03

Comparative study of intravitreal injection of razumab combined with panretinal photocoagulation and simplepanretinal photocoagulation in the treatment of high-risk incremental diabetic retinopathy.
ZHONG Zhi-wei,SHAO Dong-pin. Department of Ophthalmology, Nanhai Hospital Affiliated to Southern Medical University, Foshan 528000,Guangdong, CHINA
【Abstract】 Objective To compare the efficacy of intravitreal injection of razumab combined with panretinalphotocoagulation and panretinal photocoagulation alone in the treatment of high-risk proliferative diabetic retinopathy(PDR). Methods From June 2016 to June 2018, 35 patients (50 eyes) with high-risk PDR who were diagnosed andtreated in Department of Ophthalmology of Nanhai Hospital Affiliated to Southern Medical University were selected anddivided into the observation group (16 cases, 24 eyes) and control group (19 cases, 26 eyes) according to random num-ber table method. The observation group was treated with razumab combined with whole retina photocoagulation, whilethe control group was treated with whole retina photocoagulation alone. After 3 months of treatment, the clinical effica-cy, central macular thickness, best corrected visual acuity, laser energy, spot number and postoperative complicationswere compared between the two groups. Results After treatment, the total effective rate of the observation group was87.50%, which was significantly higher than 61.54% of the control group (P<0.01). The central macular thickness of theobservation group was (281.4±37.3) μm, which was significantly lower than (344.3±97.1) μm of the control group (P<0.01). The laser energy and spot number were (345±13) mW and (1 789±6.4) ms, respectively, which were significantlylower than corresponding (448±8) mW and (2491±7.1) ms of the control group (all P<0.05). After treatment, the best cor-rected visual acuity of the patients in the observation group was 0.56±0.05, which was significantly better than 0.42±0.02 in the control group; the incidence of postoperative complications was 16.67%, which was also significantly lowerthan 26.92% in the control group (all P<0.05). Conclusion The therapeutic effect of intravitreal injection of razumabcombined with panretinal photocoagulation is better than that of panretinal photocoagulation alone, which is worthy ofclinical application.
      【Key words】 High-risk proliferative diabetic retinopathy; Razumab; Panretinal laser photocoagulation; Therapeu-tic effect; Safety