摘要
目的 探讨复方血栓通辅助贝伐单抗治疗湿性老年黄斑变性(wAMD)的临床效果.方法 选取 2021年4 月至2023 年5 月收治的62 例wAMD患者,随机数字表法分为2 组,各31 例.单抗组予以贝伐单抗治疗,联合组予以复方血栓通联合贝伐单抗治疗,2 组均治疗3 个月.比较2 组临床疗效、最佳矫正视力(BCVA)最小分辨角对数(LogMAR)、黄斑中心凹视网膜厚度(CRT)、眼血流动力学[收缩期峰值流速(PSV)、舒张末期流速(EDV)、阻力指数(RI)]、血清因子[血管内皮生长因子(VEGF)、白细胞介素-1(IL-1)、IL-6、IL-17、血管内皮细胞生长抑制因子(VEGI)、肿瘤坏死因子-α(TNF-α)]及不良反应.结果 联合组总有效率为 93.55%(29/31)高于单抗组 70.97%(22/31)(P＜0.05).联合组治疗1、3 个月后BCVA(LogMAR)优于单抗组,CRT低于单抗组(P＜0.05);联合组治疗1、3 个月后RI、IL-6、TNF-α、IL-1、IL-17、VEGF低于单抗组,PSV、EDV、VEGI高于单抗组(P＜0.05).联合组贝伐单抗的注射次数少于单抗组(P＜0.01).2 组不良反应发生率比较无显著差异(P＞0.05).结论 复方血栓通辅助贝伐单抗治疗wAMD可有效调控血管生成因子水平,抑制促炎因子,改善眼血流动力学,减少贝伐单抗注射次数,从而改善局部病变,且治疗安全性高.
Abstract
Objective To explore the clinical effect of compound Xueshuantong and Bevacizumab in the treatment of wet age-related macular degeneration(wAMD).Methods A total of 62 wAMD patients admitted from April 2021 to May 2023 were randomly divided into two groups,with 31 patients in each group.The Bevacizumab group was treated with Bevaci-zumab,and the combined group was treated with compound Xueshuantong combined with Bevacizumab.Both groups were treated for 3 months.The clinical efficacy,best corrected visual acuity(BCVA)logarithm of the minimum angle of resolution(LogMAR),foveal retinal thickness(CRT),ocular hemodynamics[peak systolic velocity(PSV),end-diastolic velocity(EDV),resistance index(RI)],serum factors[vascular endothelial growth factor(VEGF),interleukin-1(IL-1),inter-leukin-6(IL-6),interleukin-17(IL-17),vascular endothelial growth inhibitor(VEGI),tumor necrosis factor-α(TNF-α)]and adverse reactions were compared between the two groups.Results The total effective rate of combination group was 93.55%(29/31),which was higher than that of Bevacizumab group[70.97%(22/31)](P＜0.05).At 1 and 3 months after treatment,BCVA(LogMAR)in combination group was better than that in Bevacizumab group,and CRT was lower than that in Bevacizumab group(P＜0.05).At 1 and 3 months after treatment,RI,IL-6,TNF-α,IL-1,IL-17 and VEGF in combination group were lower than those in Bevacizumab group,while PSV,EDV and VEGI were higher than those in Bevaci-zumab group(P＜0.05).The injection times of Bevacizumab in combination group was less than that in Bevacizumab group(P＜0.01).There was no significant difference in the incidence of adverse reactions between the two groups(P＞0.05).Conclusion In the treatment of wAMD,compound Xuesuantong and Bevacizumab can effectively regulate the level of angio-genic factors,inhibit pro-inflammatory factors,improve ocular hemodynamics,reduce the number of Bevacizumab injections,and thus alleviate local lesions,and the treatment is safe.
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