雷珠单抗联合曲安奈德治疗湿性年龄相关性黄斑变性的疗效及对白介素的影响

doi:10.3760/cma.j.cn115909-20190821-00231

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Abstract Objective: To observe the clinical efficacy of Ranibizumab combined with Triamcinolone acetonide in the treatment of wet age-related macular degeneration (AMD), and to explore its effects on interleukin (IL)-1β, IL-2, IL-6. The impact of IL-8 levels. Methods: This is a retrospective study. A total of 86 cases (102 eyes) of wet AMD patients admitted to Inner Mongolia Baogang Hospital from November 2017 to October 2018 were randomly divided into Ranibizumab group (43 cases, 50 eyes) and combination group (43 cases, 52 eyes). The patients in the Ranibizumab group were treated with intravitreal injection of Ranibizumab, and the combined group was treated with Triamcinolone acetonide with the same method on the basis of intravitreal injection of Ranibizumab. The intraocular pressure values of the two groups before treatment, 2 weeks, 1 month and 3 months after treatment were compared. The central retinal thickness (CMT) and visual acuity of the two groups before treatment, 1 month, 3 months and 6 months after treatment were compared. The serum levels of IL-1β, IL-2, IL-6 and IL-8 were compared between the two groups before treatment and 1 month after treatment. The complications during treatment were counted and compared. Two-sample measurement data using t test. Repeated measurement variance analysis using repeated measurement data, further comparison using LSD-t test. χ 2 test was used for two count sample data. Results: There were no significant differences between the two groups (Fgroups=1.275, P=0.496; Ftime=1.810, P=0.211; Finteraction=1.772, P=0.335). There was no significant difference in CMT and visual acuity between the two groups before treatment (t=0.042, P=0.967; t=0.720, P=0.473). At one month, three months and six months after treatment, CMT of combined group was lower than that of Ranibizumab group (t=2.086, P=0.039; t=3.398, P=0.001; t=2.987, P=0.004), and visual acuity of combined group was higher than that of Ranibizumab group at different time (t=3.265, P=0.001; t=2.217, P=0.029; t=2.519, P=0.013). The CMT decreased (tbefore treatment vs. 1 month after treatment=6.210, 4.218, P<0.001; t1 month after treatment vs. 3 months after treatment=16.772, 15.865, P<0.001; t3 months after treatment vs. 6 months after treatment=4.472, 4.848, P<0.001) and visual acuity increased (tbefore treatment vs. 1 month after treatment=4.527, 8.395, P<0.001; t1 month after treatment vs. 3 months after treatment=5.369, 5.349, P<0.001; t3 months after treatment vs. 6 months after treatment=3.335, 3.730, P<0.001) with time in both groups. Compared with before treatment, the serum levels of IL-1β, IL-6 and IL-8 in 1 month after treatment were lower in the 2 groups (tcombined group=10.544, 32.169, 33.156, all P<0.001; tRanibizumab group=8.996, 25.687, 30.754, all P<0.001), and the combined group were lower than those in the Ranibizumab group (t=2.894, P=0.005; t=5.997, P<0.001; t=3.934, P<0.001). Compared with before treatment, the serum IL-2 level in the 2 groups were higher that 3 months after treatment (t=20.067, 9.091, all P<0.001), and the combined group was higher than that in the Ranibizumab group (t=7.705, P<0.001). There were no significant difference in the rates of bleeding, intraocular foreign body sensation, transient intraocular hypertension and total complications between the two groups (correction χ2 =0.001, P=0.972; correction χ2 =0.221, P=0.638; Fisher's exact test P=0.116; correction χ2 =0.004, P=0.951). Conclusions: Intravitreal injection of Ranibizumab combined with triamcinolone acetonide can effectively improve the visual function of wet AMD, reduce CMT, relieve inflammation, and it is safe and reliable.

Key words： Ranibizumab triamcinolone acetonide age-related macular degeneration interleukin

Received: 21 August 2019

Fund:Natural Science Foundation of China (81770952)

Corresponding Authors: Xiangyang Xin, Department of Ophthalmology, Inner Mongolia Baogang Hospital, Baotou 014010, China (Email: bgyy_yk@163.com)

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