摘要
目的探究光学相干断层扫描血管成像(OCTA)与血清血管内皮细胞生长因子(VEGF)评价康柏西普治疗湿性年龄相关性黄斑变性(AMD)疗效应用效果。方法选取2021年5月至2023年5月西安市第一医院眼科收治的80例湿性AMD患者作为研究对象,其中男性49例,女性31例,患者均给予康柏西普治疗。在患者治疗6个月后,评估患者治疗效果,治疗前、治疗1个月、3个月及6个月后行最佳矫正视力(BCVA)、OCTA及血清指标检查,同时评估患者不良反应发生情况,分析OCTA及血清指标与疗效相关性。结果80例患者治疗总有效率为88.75%;治疗后,患者BCVA、眼压明显下降,治疗1个月、3个月后BCVA、眼压逐渐下降,差异有统计学意义(P<0.05);治疗后,患者中心凹浅层位置血管血流密度、中心凹浅层黄斑厚度、中心凹旁浅层黄斑厚度及脉络膜新生血管密度明显下降,治疗3个月、1个月后OCTA测定指标逐渐下降(P<0.05);治疗后患者转化生长因子-β1(TGF-β1)、VEGF、血小板衍生生长因子(PDGF)等血清指标均显著降低,治疗3个月、1个月后TGF-β1、VEGF、PDGF等血清指标逐渐下降(P<0.05);80例患者不良反应发生率为6.25%;Spearman相关分析显示,治疗6个月后,中心凹浅层位置血管血流密度、中心凹浅层黄斑厚度及中心凹旁浅层黄斑厚度、脉络膜新生血管密度与疗效呈负相关(r=-0.613、-0.532、-0.547、-0.496,P<0.05);治疗6个月后,TGF-β1、VEGF、PDGF血清指标水平与疗效呈负相关(r=-0.567、-0.483、-0.672,P<0.05)。结论康柏西普用于治疗湿性AMD疗效优异,而OCTA与血清VEGF可以有效反映湿性AMD接受康柏西普治疗病情变化,为患者病情评估提供更多有效参考依据。
Objective To explore the feasibility of optical coherence tomography angiography(OCTA)and serum vascular endothelial growth factor(VEGF)in evaluating conbercept in the treatment of wet age⁃related macular degeneration(AMD).Methods A total of 80 patients with wet AMD admitted to the Ophthalmology Department of Xi'an First Hospital from May 2021 to May 2023 were selected as the study objects,including 49 males and 31 females,all of whom were treated with Conbercept.The therapeutic effect of patients was evaluated after 6 months of treatment,and the best corrected visual a⁃cuity(BCVA),OCTA and serum indexes were examined before treatment,1 month,3 months and 6 months after treatment.At the same time,the incidence of adverse reactions in patients was evaluated,and the correlation between OCTA and serum indexes and curative effect was analyzed.Results The total effective rate of 80 patients was 88.75%;After treatment,BC⁃VA and iOP decreased significantly,and BCVA and iOP decreased gradually after 1 month and 3 months of treatment,with statistically significant difference(P<0.05);After treatment,blood flow density and macular thickness in shallow fovea,macular thickness and choroidal neovascular density in shallow layer of fovea and parafovea decreased significantly,and OCTA index decreased gradually after 3 months and 1 month after treatment(P<0.05);After treatment,the serum indexes such as transforming growth factor⁃β1(TGF⁃β1),VEGF and platelet⁃derived growth factor(PDGF)significantly decreased,and the serum indexes such as TGF⁃β1,VEGF and PDGF gradually decreased after 3 months and 1 month after treatment(P<0.05);The incidence of adverse reactions in 80 patients was 6.25%;Spearman correlation analysis showed that after 6 months of treatment,the blood flow density in shallow fovea,the thickness of macula in shallow layer of fovea and parafovea,and choroidal neovascular density were negatively correlated with the curative effect(r=-0.613,-0.532,-0.547,-0.496,P<0.05).After 6 months of treatment,TGF⁃β1,VEGF,PDGF and other serum indexes were negatively correla⁃ted with the therapeutic effect(r=-0.567,-0.483,-0.672,P<0.05).Conclusion Conbercept has excellent effica⁃cy in the treatment of wet AMD,and OCTA and serum VEGF can effectively reflect the changes in the condition of wet AMD treated with Conbercept,providing more effective reference for the evaluation of patients'condition.
作者
朱红娜
王昞
苏安乐
陆慧琴
曲晓瑜
ZHU Hongna;WANG Bing;SU Anle;LU Huiqin;QU Xiaoyu(Department of Ophthalmology,Xi'an First Hospital,Xi'an,Shaanxi 710006,China)
出处
《转化医学杂志》
2024年第7期1031-1035,共5页
Translational Medicine Journal
基金
陕西省重点研发计划项目(2022SF-312)。
