雷珠单抗联合不同剂量维替泊芬光动力疗法治疗CSC合并CNV的临床疗效<sup>*</sup>

doi:10.3969/j.issn.1671-7171.2024.02.005

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摘要【目的】探讨雷珠单抗联合不同剂量维替泊芬光动力疗法治疗慢性中心性浆液性脉络膜视网膜病变(CSC)合并脉络膜新生血管(CNV)的临床疗效。【方法】选取2014年2月至2019年12月上海健康医学院附属嘉定区中心医院收治的103例慢性CSC合并CNV患者,根据治疗方法的不同分为常规组[58例58眼,采用雷珠单抗+小剂量(1 mg/m²)维替泊芬光动力疗法治疗]和观察组[55例55眼,雷珠单抗+采用半剂量(3 mg/m²)维替泊芬光动力疗法治疗]。比较两组患者临床疗效、不良反应发生率及治疗前后视网膜下液隆起最高点高度(HPSF)、最佳矫正视力(BCVA)、视网膜中央静脉血流动力学参数[最大血流速度(V_max)、最低血流速度(V_min)]。【结果】观察组总有效率高于常规组(P<0.05)。治疗前,两组患者HPSF、BVCA比较,差异无统计学意义(P>0.05);治疗后,两组患者HPSF均降低,且观察组低于常规组(P＜0.05);治疗后,两组患者BCVA均升高,且观察组高于常规组(P<0.05)。治疗前,两组患者V_max、V_min比较,差异无统计学意义(P>0.05);治疗后,两组患者V_max、V_min均降低,且观察组低于常规组(P<0.05)。常规组眼压升高1例,恶心、呕吐2例,不良反应发生率为5.17%;观察组眼压升高2例,恶心、呕吐2例,不良反应发生率为7.27%。两组不良反应发生率比较,差异无统计学意义(P>0.05)。【结论】采用雷珠单抗联合半剂量维替泊芬光动力疗法治疗慢性CSC合并CNV的效果显著,可改善患者视力和视网膜中央静脉血流动力学指标,且安全可靠。

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关键词 ：抗体, 单克隆/治疗应用, 中心性浆液性脉络膜视网膜病变/治疗, 光化学疗法, 治疗结果

Abstract：【Objective】To explore the clinical efficacy of ranibizumab combined with different doses of vitipofen photodynamic therapy in the treatment of chronic central serous chorioretinopathy (CSC) with choroidal neovascularization (CNV). 【Methods】A total of 103 patients with chronic CSC complicated with CNV admitted to Jiading District Central Hospital affiliated with Shanghai Health Medical College from February 2014 to December 2019 were selected. According to different treatment methods, they were divided into a conventional group [58 cases, 58 eyes, treated with ranibizumab and low-dose (1 mg/m²) Vitipofen photodynamic therapy] and an observation group [55 cases, 55 eyes, treated with ranibizumab and half dose (3 mg/m²) Vitipofen photodynamic therapy]. We compared the clinical efficacy, incidence of adverse reactions, height of subretinal fluid protrusion (HPSF), best corrected visual acuity (BCVA), and hemodynamic parameters of the central retinal vein (V_max and V_min) between two groups of patients before and after treatment. 【Results】The total effective rate of the observation group was higher than that of the control group (P<0.05). Before treatment, there was no statistically significant difference in HPSF and BVCA between the two groups of patients (P>0.05);After treatment, HPSF was decreased in both groups, and the observation group was lower than the conventional group (P<0.05). After treatment, BCVA increased in both groups, and the observation group was higher than the conventional group (P<0.05). Before treatment, there was no statistically significant difference in V_max and V_min between the two groups of patients (P>0.05); After treatment, V_max and V_min decreased in both groups of patients, and the observation group was lower than the control group (P<0.05). In the conventional group, there was 1 case of elevated intraocular pressure, 2 cases of nausea and vomiting, and the incidence of adverse reactions was 5.17%; In the observation group, there were 2 cases of elevated intraocular pressure, 2 cases of nausea and vomiting, and the incidence of adverse reactions was 7.27%. There was no statistically significant difference in the incidence of adverse reactions between the two groups (P>0.05). 【Conclusion】The combination of ranibizumab and half dose vitipofen photodynamic therapy had a significant effect on the treatment of chronic CSC complicated with CNV. It can improve the visual acuity and central retinal vein hemodynamic indicators of patients, and is safe and reliable.

Key words： Antibodies, Monoclonal/TU Central Serous Chorioretinopathy/TH Photochemotherapy Treatment Outcome

收稿日期: 2023-10-19

中图分类号:

R774.1

基金资助:*上海市嘉定区自然科学研究课题(JDKW-2021-0026)

通讯作者: **E-mail:396429437@qq.com

引用本文:

赖忠燕, 曹文捷, 周群, 宋霞云, 高凤娟, 吴晓方. 雷珠单抗联合不同剂量维替泊芬光动力疗法治疗CSC合并CNV的临床疗效^*[J]. 医学临床研究, 2024, 41(2): 174-177.
LAI Zhongyan, CAO Wenjie, ZHOU Qun, et al. Clinical Efficacy of Combination Therapy of Ranibizumab and Different Doses of Vitipofen Photodynamic Therapy in the Treatment of CSC Complicated with CNV. JOURNAL OF CLINICAL RESEARCH, 2024, 41(2): 174-177.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2024.02.005 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2024/V41/I2/174

[1] 杨慧玲,熊师,郭燕,等.早产儿视网膜病变的筛查及临床分析[J].医学临床研究, 2020, 27(12):93-103.
[2] 梁怡.糖尿病视网膜病变120例临床分析[J].医学临床研究, 2019,6(1):2-4.
[3] 王晓刚,张洁,虞仁和,等. 急性与慢性中心性浆液性脉络膜视网膜病变视网膜微血管改变的对比研究[J].中南大学学报(医学版),2022,47(8):1075-1081.
[4] 张少华,张超,申亚贤,等. 577 nm微脉冲激光治疗慢性中心性浆液性脉络膜视网膜病变[J].国际眼科杂志,2022,22(9):1564-1568.
[5] 朱华凤,许阿敏. 慢性中心性浆液性脉络膜视网膜病变光动力治疗前后超广角眼底自身荧光的变化[J].武汉大学学报(医学版),2022,43(2):294-297.
[6] 闫琼,李秋明,董淑倩,等. 玻璃体内注射雷珠单抗治疗中心性浆液性脉络膜视网膜病变的临床观察[J].中华眼外伤职业眼病杂志,2018,40(4):254-257.
[7] 邱新文,任旋,兰丽霞,等. 光学相干断层扫描血管成像引导光动力疗法治疗慢性中心性浆液性脉络膜视网膜病变[J].眼科新进展,2019,39(8):767-771.
[8] 石薇,张贵森,惠延年,等. 微脉冲激光与PDT治疗慢性中心性浆液性脉络膜视网膜病变的疗效比较[J].国际眼科杂志,2019,19(6):1063-1067.
[9] 杜向红,刘勇,陈威,等. 半剂量维替泊芬光动力治疗飞行员中心性浆液性脉络膜视网膜病变一例并文献复习[J].中华航空航天医学杂志,2020,31(1):23-26.
[10] 黄叔仁, 张晓峰. 眼底病诊断与治疗[M].2版.北京:人民卫生出版社, 2008:30-41.
[11] 魏丽,李桦,王平. 新生血管性、非新生血管性CSC患者黄斑区脉络膜和视网膜的血流密度及形态结构观察[J].山东医药,2022,62(12):19-23.
[12] 赵玥,张苏,臧晓,等. 靶向导航激光连续波阈值下功率治疗慢性中心性浆液性脉络膜视网膜病变的疗效观察[J].中华眼底病杂志,2021,37(8):599-604.
[13] 张小文,李勇,蔡佳玉. CSC患者黄斑色素光密度与视网膜中央厚度及脉络膜厚度的关系[J].东南大学学报(医学版),2021,40(5):627-632.
[14] 陈威,高晶,朱晖,等. 螺内酯联合30％剂量维替泊芬光动力疗法治疗慢性中心性浆液性脉络膜视网膜病变[J].医药导报,2019,37(10):1220-1223.
[15] 顾晖晖,浦利军,黄爱萍,等. 雷珠单抗联合脉冲激光治疗慢性CSC合并CNV的临床疗效观察[J].海军医学杂志,2023,44(3):275-278.
[16] 王冬艳,王丽英,杨娜,等. 雷珠单抗联合视网膜激光光凝治疗青年增殖型糖尿病视网膜病变的效果及安全性[J].河北医药,2022,44(23):3630-3632.
[17] 马为梅,雷晓琴,田芳,等. 半剂量维替泊芬与半能量光动力疗法治疗慢性中心性浆液性脉络膜视网膜病变[J].眼科新进展,2019,37(4):341-343.
[18] 孙昕,王晶. 半剂量维替泊芬光动力疗法治疗慢性CSCR的回顾性研究[J].国际眼科杂志,2019,3(10):1823-1825.