摘要
目的观察曲安奈德联合康柏西普在雷珠单抗治疗效果不佳的湿性年龄相关性黄斑变性(wet age-related macular degeneration,wAMD)中的应用效果。方法本研究为前瞻性研究,选择沧州市眼科医院2023年8月至2024年8月收治的188例对雷珠单抗治疗效果不佳的wAMD患者为研究对象,随机数字表法将其分成对照组和研究组,每组各纳入94例。对照组患者给予康柏西普,研究组患者给予曲安奈德联合康柏西普,均治疗3个月。比较两组患者治疗前后最佳矫正视力(BCVA)、眼压(IOP)、黄斑中心凹厚度(CMT)、眼底损伤情况以及复发率。结果对照组和研究组治疗后IOP[分别是(16.01±2.33)mm Hg(1 mm Hg≈0.133 kPa)、(16.08±2.35)mm Hg],高于治疗前[分别是(15.55±1.45)mm Hg、(15.53±1.46)mm Hg],差异无统计学意义(t=0.205,P>0.05)。对照组和研究组治疗后BCVA[分别是(15.36±2.22)、(17.65±3.35)],高于治疗前[分别是(10.56±3.11)、(10.59±3.10)],研究组高于对照组(t=5.525,P<0.05)。对照组和研究组治疗后CMT[分别是(356.20±56.14)μm、(271.69±62.25)μm],低于治疗前[分别是(436.65±96.36)μm、(434.64±95.34)μm],且研究组低于对照组(t=9.774,P<0.05)。对照组和研究组治疗后出血面积、累及损伤面积、渗漏面积[分别是(0.89±0.55)mm^(2)、(0.50±0.41)mm^(2)、(0.96±0.47)mm^(2)、(0.63±0.17)mm^(2)、(2.88±0.68)mm^(2)、(2.10±0.17)mm^(2)],低于治疗前[分别是(1.25±0.58)mm^(2)、(1.23±0.57)mm^(2)、(1.98±0.36)mm^(2)、(1.94±0.33)mm^(2)、(3.87±1.03)mm^(2)、(3.84±1.00)mm^(2)],且研究组低于对照组,差异具有统计学意义(t=5.512、6.401、10.789,P<0.05)。研究组患者复发率(1.06%)低于对照组(19.15%)(χ^(2)=16.921,P=0.000)。结论康柏西普与曲安奈德联合应用于雷珠单抗治疗效果不好的wAMD患者,其疗效明确,可有效减轻血管异常增生,减轻临床症状,促进视力恢复且复发率较低。
Objective To investigate the efficacy of triamcinolone conbercept with compaucil in the treatment of wet age-related macular degeneration(wAMD)with poor response to ranibizumab.Methods A total of 188 patients with wAMD who exhibited a poor response to ranibizumab treatment admitted to Cangzhou Eye Hospital from August 2023 to August 2024 were retrospectively enrolled in this study.They were divided into the control group and study group by random number table method,with 94 in each group.The patients in the control group received treatment with conbercept while those in the study group received treatment with triamcinolone acetonide in combination with conbercept.All the patients in both groups were treated for 3 months.Comparisons were conducted between the two groups regarding best-corrected visual acuity(BCVA),intraocular pressure(IOP),central macular thickness(CMT),fundus damage and recurrence rate before and after treatment.Results The IOP of the control group and study group after treatment((16.01±2.33)mm Hg(1 mm Hg≈0.133 kPa)and(16.08±2.35)mm Hg,respectively)was higher than that before treatment((15.55±1.45)mm Hg and(15.53±1.46)mm Hg,respectively),but there was no statistical difference between the two groups(t=0.205,P>0.05).The BCVA of of the control group and study group after treatment((15.36±2.22)and(17.65±3.35),respectively)was higher than that before treatment((10.56±3.11)and(10.59±3.10),respectively),and it was significantly higher in the study group than in the control(t=5.525,P<0.05).After treatment,the CMT in the control group and study group((356.20±56.14)μm and(271.69±62.25)μm,respectively)was lower than that before treatment((436.65±96.36)μm and(434.64±95.34)μm,respectively),and it was significantly lower in the study group than in the control(t=9.774,P<0.05).The areas of bleeding,damage and leakage in the con trol group and study group after treatment were(0.89±0.55)mm^(2),(0.50±0.41)mm^(2),(0.96±0.47)mm^(2),(0.63±0.17)mm^(2),(2.88±0.68)mm^(2),and(2.10±0.17)mm^(2),respectively,which were lower than those of(1.25±0.58)mm^(2),(1.23±0.57)mm^(2),(1.98±0.36)mm^(2),(1.94±0.33)mm^(2),(3.87±1.03)mm^(2),and(3.84±1.00)mm^(2) before treatment,and they were remarkably lower in the study group than in the control(t=5.512,6.401,10.789,P<0.05).The recurrence rate was 1.06%in the study group and it was lower than that of 19.15%in the control,(χ^(2)=16.921,P=0.000).Conclusion The combination of conbercept with triamcinolone acetonide in invalids with wAMD who have poor response to ranibizumab has clear clinical efficacy since it can effectively reduce vascular dysplasia,alleviate clinical symptoms,promote visual recovery and results in a low recurrence rate.
作者
刘雅雯
张立友
吴文文
路露
Liu Ya-wen;Zhang Li-you;Wu Wen-wen;Lu Lu(Department of Fundus Diseases,Cangzhou Eye Hospital,Cangzhou 061000,China;Department of Cataracts,Cangzhou Eye Hospital,Cangzhou 061000,China)
出处
《中国药物应用与监测》
2025年第1期87-91,共5页
Chinese Journal of Drug Application and Monitoring
