目的 評(píng)估康柏西普眼用注射液聯(lián)合小劑量曲安奈德注射液治療滲出型老年性黃斑變性的臨床療效。方法 選取2012年1月-2015年1月在咸陽(yáng)市第一人民醫(yī)院眼科就診并住院治療的74例滲出型老年性黃斑變性患者,共80只眼。將所有患者以就診單雙號(hào)為標(biāo)準(zhǔn)對(duì)患者進(jìn)行分組,其中單號(hào)為對(duì)照組,雙號(hào)為治療組,每組各37例40只眼。對(duì)照組球內(nèi)注射曲安奈德注射液,0.1 mL/次,1次/d。治療組球內(nèi)注射曲安奈德注射液減量至0.025 mL/次基礎(chǔ)上球內(nèi)注射康柏西普眼用注射液,0.05 mL/次,1次/月。兩組均連續(xù)治療3個(gè)月。觀察兩組視力改善和黃斑部熒光滲漏及遮蔽熒光改善的臨床療效,同時(shí)比較兩組治療前后與治療后1、2、3個(gè)月黃斑中心凹視網(wǎng)膜厚度、最佳矯正視力、眼壓值和生活質(zhì)量評(píng)分。結(jié)果 治療3個(gè)月后,對(duì)照組和治療組視力改善和黃斑部熒光滲漏及遮蔽熒光改善的總有效率分別為80.00%、95.00%,75.00%、92.50%,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療3個(gè)月后兩組黃斑中心凹視網(wǎng)膜厚度、最佳矯正視力、眼壓值比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.01、0.05)。治療后兩組除讀和精細(xì)工作外其他各項(xiàng)指標(biāo)均有明顯變化(P<0.05、0.01);治療組第1、2、3個(gè)月遠(yuǎn)視力等、調(diào)節(jié)能力、讀和精細(xì)工作、日常生活能力評(píng)分均顯著高于對(duì)照組(P<0.05)。結(jié)論 康柏西普眼用注射液聯(lián)合小劑量曲安奈德注射液治療滲出型老年性黃斑變性具有較好的臨床效果,能有效改善患者視功能,提升生活質(zhì)量,且不良反應(yīng)少,安全性較高,具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To evaluate the clinical efficacy of Conbercept Ophthalmic Injection combined with Triamcinolone Acetonide Injection in treatment of exudative age-related macular degeneration (AMD). Methods Patients (74 cases, 80 eyes) with exudative AMD in Department of Ophthalmology of The First People's Hospital of Xianyang City from January 2012 to January 2015 were divided into control and treatment groups according to the visiting single or even numbers, and each group had 37 cases or 40 eyes. The patients in the control group were intraocular injection administered with Triamcinolone Acetonide Injection, 0.1 mL/time, once daily. The patients in the treatment group were intraocular injected with Conbercept Ophthalmic Injection on the basis of control group with Triamcinolone Acetonide Injection 0.025 mL/time, 0.05 mL/time, once monthly. The patients in two groups were treated for 3 months. After treatment, the clinical efficacies of vision improvement and improvement of fluorescence leakage and shading in the macular were evaluated. And thickness of the retina, the best corrected visual acuity, intraocular pressure, quality of life in two groups before treatment and after treatment for 1, 2, and 3 months were compared. Results After treatment, the efficacy of vision improvement and improvement of fluorescence leakage and shading in the macular in the control and treatment groups were 80.00%, 95.00%, 75.00%, and 92.50%, respectively, and there were differences between two groups (P < 0.05). After treatment for 3 months, thickness of the retina and the best corrected visual acuity in the treatment group were significantly better than those in the control group, with significant difference between two groups (P < 0.01). But there was no significant difference on intraocular pressure between two groups. After treatment, quality of life indexes except reading and fine work in two groups had obvious changes, and the difference was statistically significant in the same group (P < 0.05, 0.01). After treatment in the 1^st, 2nd, and 3rd month, distant visual acuity, adjustment ability, reading and fine work, and daily life ability score in the treatment group were higher than those in the control group (P < 0.05). Conclusion Conbercept Ophthalmic Injection combined with Triamcinolone Acetonide Injection has clinical curative effect in the treatment of AMD, can effectively improve the visual function, improve the quality of life, and less adverse reaction, high security, which has a certain clinical application value.