玻璃体腔注射雷珠单抗对增殖性糖尿病性视网膜病变患者视力及血清GAS6、SDF-1与VEGF的影响
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摘要
目的:考察玻璃体腔注射雷珠单抗对增殖性糖尿病性视网膜病变(PDR)患者视力及血清中人生长停滞特异性蛋白6(GAS6)、人基质细胞衍生因子1(SDF-1)与血管内皮细胞生长因子(VEGF)的影响。方法:回顾性分析2012年3月-2014年3月在我院诊断为PDR的56例患者资料,分为单侧眼组29例和双侧眼组27例。所有患者均行单次玻璃体腔注射雷珠单抗注射液,在治疗前及治疗后1、4、8周对患者血清中GAS6、SDF-1与VEGF水平进行检测,在治疗前及治疗后1周对患者视力进行检查。结果:治疗后1、4、8周,单侧眼组与双侧眼组患者的GAS6、SDF-1、VEGF水平与治疗前比较均明显降低,差异有统计学意义(P<0.05),但组间比较差异无统计学意义(P>0.05)。治疗后1周,单侧眼组与双侧眼组患者的最佳矫正视力(BCVA)看到的字母数与治疗前比较明显增多,差异有统计学意义(P<0.05),但组间比较差异无统计学意义(P>0.05)。结论:PDR患者玻璃体腔注射雷珠单抗后能有效提高视力水平。
OBJECTIVE:To investigate the effect of intravitreal injection of ranibizumab on visual acuity and GAS6,SDF-1and VEGF levels in serum of patients with proliferative diabetic retinopathy lesions. METHODS:56 patients diagnosed as proliferative diabetic retinopathy in our hospital during Mar. 2012 to Mar. 2014 were analyzed retrospectively and divided into simple lateral eyes group(29 cases)and bilateral eyes group(27 cases). All patients received single intravitreal injection of ranibizumab. The serum levels of GAS6,SDF-1 and VEGF were detected before treatment and 1,4 and 8 weeks after treatment. The visual acuity of patients were detected before treatment and 1 week after treatment. RESULTS:1,4 and 8 weeks after treatment,the serum levels of GAS6,SDF-1 and VEGF in 2 groups were decreased significantly,with statistical significance(P<0.05);but there was no statistical significance between 2 groups(P>0.05). 1 week after treatment,the number of letter which had been seen by patient's BCVA were increased,compared to before treatment,with statistical significance(P<0.05);but there was no statistical significance between 2 groups(P>0.05). CONCLUSIONS:Intravitreal injection of ranibizumab can improve visual acuity of patients with proliferative diabetic retinopathy.
OBJECTIVE:To investigate the effect of intravitreal injection of ranibizumab on visual acuity and GAS6,SDF-1and VEGF levels in serum of patients with proliferative diabetic retinopathy lesions. METHODS:56 patients diagnosed as proliferative diabetic retinopathy in our hospital during Mar. 2012 to Mar. 2014 were analyzed retrospectively and divided into simple lateral eyes group(29 cases)and bilateral eyes group(27 cases). All patients received single intravitreal injection of ranibizumab. The serum levels of GAS6,SDF-1 and VEGF were detected before treatment and 1,4 and 8 weeks after treatment. The visual acuity of patients were detected before treatment and 1 week after treatment. RESULTS:1,4 and 8 weeks after treatment,the serum levels of GAS6,SDF-1 and VEGF in 2 groups were decreased significantly,with statistical significance(P<0.05);but there was no statistical significance between 2 groups(P>0.05). 1 week after treatment,the number of letter which had been seen by patient's BCVA were increased,compared to before treatment,with statistical significance(P<0.05);but there was no statistical significance between 2 groups(P>0.05). CONCLUSIONS:Intravitreal injection of ranibizumab can improve visual acuity of patients with proliferative diabetic retinopathy.
引文
[1]王友,邓铂林,黄健,等.玻璃体腔注射雷珠单抗治疗严重增生型糖尿病性视网膜病变后玻璃体细胞因子的变化[J].中华眼底病杂志,2014,30(5):484.
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[11]何跃,陈洁,吕红彬.蛋白激酶C-β抑制剂Ruboxistaurin治疗糖尿病性视网膜病变的研究进展[J].中国药房,2010,21(37):3 540.
[12]Acosta C,Alezzandrini A,Bafalluy J,et al.Defining Best Practice Standards for the Diagnosis and Management of Diabetic Retinopathy and Diabetic Macular Edema in Latin America[J].PAAO,2014,13(3 Suppl):3.
[13]李素华,游志鹏.玻璃体内注射雷珠单抗治疗老年黄斑变性合并视网膜中央静脉阻塞的疗效[J].中国老年学杂志,2014,34(23):6 661.
[14]万珊珊,杨燕宁,邢怡桥,等.雷珠单抗治疗视网膜静脉阻塞继发黄斑水肿的效果及安全性的系统评价[J].中国医药导报,2013,10(27):62.
[2]Diabetic Retinopathy Clinical Research Network,Googe J,Brucker AJ,et al.Randomized trial evaluating shortterm effects of intravitreal ranibizumab or triamcinolone acetonide on macular edema following focal/grid laser for diabetic macular edema in eyes also receiving panretinal photocoagulation[J].Retina,2011,31(6):1 009.
[3]王帅,吴强.Müller细胞生理功能及其在糖尿病性视网膜病变中的变化[J].中华眼底病杂志,2014,30(2):219.
[4]Diabetic Retinopathy Clinical Research Network.Randomized clinical trial evaluating intravitreal ranibizumab or saline for vitreous hemorrhage from proliferative diabetic retinopathy[J].JAMA Ophthalmol,2013,131(3):283.
[5]王海彬,王东华,张铁民.菩人丹超微粉对糖尿病大鼠视网膜VEGF蛋白表达的影响[J].中国药房,2011,22(23):2 119.
[6]董蒙,陈松.雷珠单抗治疗糖尿病黄斑水肿研究进展[J].中国实用眼科杂志,2014,32(6):686.
[7]Bhavsar AR,Torres K,Glassman AR,et al.Evaluation of results1year following short-term use of ranibizumab for vitreous hemorrhage due to proliferative diabetic retinopathy[J].JAMA Ophthalmol,2014,132(7):889.
[8]Bressler SB,Qin H,Melia M,et al.Exploratory analysis of the effect of intravitreal ranibizumab or triamcinolone on worsening of diabetic retinopathy in a randomized clinical trial[J].JAMA Ophthalmology,2013,131(8):1 033.
[9]Mac Dougall NJ,Muir KW.Hyperglycaemia and infarct size in animal models of middle cerebral artery occlusion:systematic review and meta-analysis[J].J Cerebr Blood F Met,2011,31(3):807.
[10]陈轩,李华萍.组蛋白去乙酰化酶抑制剂在糖尿病治疗中的作用[J].上海交通大学学报:医学版,2012,32(12):1 641.
[11]何跃,陈洁,吕红彬.蛋白激酶C-β抑制剂Ruboxistaurin治疗糖尿病性视网膜病变的研究进展[J].中国药房,2010,21(37):3 540.
[12]Acosta C,Alezzandrini A,Bafalluy J,et al.Defining Best Practice Standards for the Diagnosis and Management of Diabetic Retinopathy and Diabetic Macular Edema in Latin America[J].PAAO,2014,13(3 Suppl):3.
[13]李素华,游志鹏.玻璃体内注射雷珠单抗治疗老年黄斑变性合并视网膜中央静脉阻塞的疗效[J].中国老年学杂志,2014,34(23):6 661.
[14]万珊珊,杨燕宁,邢怡桥,等.雷珠单抗治疗视网膜静脉阻塞继发黄斑水肿的效果及安全性的系统评价[J].中国医药导报,2013,10(27):62.