山东大学耳鼻喉眼学报 ›› 2022, Vol. 36 ›› Issue (5): 46-50.doi: 10.6040/j.issn.1673-3770.0.2021.263

• 论著 • 上一篇    下一篇

卵磷脂络和碘胶囊辅助治疗视网膜静脉阻塞的临床疗效研究

顾冉冉1,李凤娇2,焦万珍2,崔艳艳1,赵博军2   

  1. 1. 山东中医药大学 第一临床医学院, 山东 济南 250014;
    2. 山东第一医科大学附属省立医院 眼科, 山东 济南 250021
  • 发布日期:2022-09-20
  • 通讯作者: 赵博军. E-mail:15168860708@163.com
  • 基金资助:
    山东省自然科学基金项目(ZR2019MH111)

Clinical efficacy of lecithin complex iodine capsule in the adjuvant treatment of retinal vein occlusion

GU Ranran1, LI Fengjiao2, JIAO Wanzhen2, CUI Yanyan1, ZHAO Bojun2   

  1. 1. First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan 250014, Shandong, China;
    2. Department of Ophthalmology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, Shandong, China
  • Published:2022-09-20

PDF (PC)

1145

摘要： 目的 探究卵磷脂络合碘胶囊联合雷珠单抗对视网膜静脉阻塞继发黄斑水肿(RVO-ME)的临床疗效。 方法 选取2020年1月至2021年2月就诊的40例40眼RVO-ME患者为研究对象,随机分为两组,雷珠单抗组和卵磷脂联合组,雷珠单抗组19例,卵磷脂联合组 21例,雷珠单抗组每4周给予玻璃体腔内注射雷珠单抗治疗,卵磷脂联合组是在雷珠单抗组治疗的基础上加用卵磷脂络合碘胶囊治疗,治疗 12 周,治疗期间每4周随访一次,观察治疗前后眼压、最佳矫正视力(BCVA)、眼底出血面积、黄斑中心区厚度(CMT)、 中心凹无血管区(FAZ)、 脉络膜血流面积(CFA)、浅层视网膜毛细血管层(SCP)和深层视网膜毛细血管层(DCP)的血管密度变化,并观察有无不良事件和不良反应的发生。 结果 两组患者各治疗时间点BCVA(LogMAR)、CMT均较治疗前改善,组间比较均无统计学差异。FAZ、SCP两组患者治疗前后无统计学差异,且组间比较无统计学差异。两组患者各治疗时间点眼底出血面积均较治疗前减少,卵磷脂联合组各治疗时间点的眼底出血吸收情况均优于雷珠单抗组,差异具有统计学意义。两组患者治疗前后CFA有增加趋势,差异具有统计学意义,组间比较无统计学差异。随访12周,两组患眼DCP呈明显增加趋势,差异具有统计学意义,且卵磷脂联合组DCP改善情况优于雷珠单抗组,差异具有统计学意义。 结论 卵磷脂络合碘胶囊辅助治疗视网膜静脉阻塞能更好地促进眼底出血的吸收、增加深层视网膜毛细血管密度,无明显不良反应。

关键词: 视网膜静脉阻塞, 雷珠单抗, 卵磷脂络和碘, 黄斑水肿

Abstract: Objective To explore the clinical efficacy of lecithin complex iodine capsule combined with ranibizumab in the treatment of macular edema secondary to retinal vein occlusion(RVO-ME). Methods 40 patients(40 eyes)with RVO-ME who were admitted to our hospital from January 2020 to February 2021 were randomly divided into two groups: ranibizumab group and lecithin combination group, 19 cases(19 eyes)in ranibizumab group and 21 cases(21 eyes)in lecithin combination group. The patients in ranibizumab group were treated with intravitreal injection of ranibizumab every 4 weeks, and the patients in lecithin combined group were treated with lecithin complex iodine capsule combined with ranibizumab every 4 weeks, follow-up every 4 weeks during the 12 weeks observation period, The changes of intraocular pressure(IOP), best-corrected visual acuity(BCVA), fundus bleeding area, central macular thickness(CMT), fovea avascular zone(FAZ), choriocaphillaris flow area(CFA), superficial capillary plexus(SCP)and deep capillary plexus(DCP)were observed before and after treatment. Results BCVA(LogMAR)and CMT of the two groups at each treatment time point were significantly improved compared with those before treatment, and there was no significant difference between the two groups. FAZ and SCP: there was no significant difference between the two groups before and after treatment, and there was no significant difference between the two groups. Fundus hemorrhage area: the fundus hemorrhage area of the two groups at each treatment time point was significantly lower than that before treatment. The fundus hemorrhage absorption of the lecithin combined group at each treatment time point was better than that of the ranibizumab group, and the difference was statistically significant. CFA in the eyes of the two groups increased before and after teatment, the difference was statistically significant, and there was no significant difference between the two groups. After 12 weeks of follow-up, DCP in the eyes of the two groups showed a significant increase trend, the difference was statistically significant, and the improvement of DCP in lecithin combined group was better than that in leizumab group, the difference was statistically significant. Conclusions Lecithin complex iodine capsule in the adjuvant treatment of retinal vein occlusion can achieve a better result in promoting the absorption of fundus hemorrhage and increase the density of deep retinal capillaries.

Key words: Retinal Vein Occlusion, Ranibizumab, Lecithin Complex Iodine, Macular Edema

中图分类号: 

  • R774.1
[1] Daruich A, Matet A, Moulin A, et al. Mechanisms of macular edema: Beyond the surface[J]. Prog Retin Eye Res, 2018, 63: 20-68. doi:10.1016/j.preteyeres.2017.10.006.
[2] Rogers S, McIntosh RL, Cheung N, et al. The prevalence of retinal vein occlusion: pooled data from population studies from the United States, Europe, Asia, and Australia[J]. Ophthalmology, 2010,117(2): 313-319.e1. doi:10.1016/j.ophtha.2009.07.017.
[3] Ng DSC, Fung NSK, Yip FLT, et al. Ranibizumab for myopic choroidal neovascularization[J]. Expert Opin Biol Ther, 2020, 20(12): 1385-1393. doi:10.1080/14712598.2021.1830969.
[4] Campa C, Alivernini G, Bolletta E, et al. Anti-VEGF therapy for retinal vein occlusions[J]. Curr Drug Targets, 2016, 17(3): 328-336. doi:10.2174/1573399811666150615151324.
[5] 詹凌. 观察卵磷脂络合碘片(沃丽汀)治疗黄斑水肿的临床疗效[J]. 2016, 32(6): 887-889, 891. doi:10.3969/j.issn.1000-484X.2016.06.026. ZHAN Ling. Study on efficacy of iodized lecithin tablets in treatment of macular edema[J]. Chinese Journal of Immunology, 2016, 32(6): 887-889, 891. doi:10.3969/j.issn.1000-484X.2016.06.026.
[6] 栗洵, 陈琳琳. 激光光凝眼底联合卵磷脂络合碘片治疗中心性浆液性脉络膜视网膜病变的效果[J]. 中国医药导报, 2015, 12(36): 101-104. LI Xun, CHEN Linlin. Effect of laser photocoagulation fundus combined with Iodized Lecithin Tablets in the treatment of central serous chorioretinopathy[J]. China Medical Herald, 2015, 12(36): 101-104.
[7] Schmidt-Erfurth U, Garcia-Arumi J, Gerendas BS, et al. Guidelines for the management of retinal vein occlusion by the European society of Retina specialists(EURETINA)[J]. Ophthalmol J Intd' Ophtalmologie Int J Ophthalmol Zeitschrift Fur Augenheilkunde, 2019, 242(3): 123-162. doi:10.1159/000502041.
[8] 韩克阳, 于贝贝, 赵博军. 短期视网膜静脉阻塞抗VEGF治疗后黄斑区形态结构分析[J]. 山东大学耳鼻喉眼学报, 2019, 33(5): 129-131. doi:10.1159/000455809.0.2017.515. HAN Keyang, YU Beibei, ZHAO Bojun. Morphological structure analysis of the macular area after anti-VEGF treatment for short-term retinal vein occlusion[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(5): 129-131.doi:10.1159/000455809.0.2017.515.
[9] Cunha-Vaz J. The blood-retinal barrier in the management of retinal disease: EURETINA award lecture[J]. Ophthalmologica, 2017, 237(1): 1-10. doi:10.1159/000455809.
[10] Cachafeiro M, Bemelmans AP, Samardzija M, et al. Hyperactivation of Retina by light in mice leads to photoreceptor cell death mediated by VEGF and retinal pigment epithelium permeability[J]. Cell Death Dis, 2013, 4: e781. doi:10.1038/cddis.2013.303.
[11] Xia JP, Wang S, Zhang JS. The anti-inflammatory and anti-oxidative effects of conbercept in treatment of macular edema secondary to retinal vein occlusion[J]. Biochem Biophys Res Commun, 2019,508(4): 1264-1270. doi:10.1016/j.bbrc.2018.12.049.
[12] Sugimoto M, Kondo M. Lecithin-bound iodine prevents disruption of tight junctions of retinal pigment epithelial cells under hypoxic stress[J]. J Ophthalmol, 2016, 2016: 9292346. doi:10.1155/2016/9292346.
[13] Lee A, Taylor P, Kalpathy-Cramer J, et al. Machine learning has arrived![J]. Ophthalmology, 2017, 124(12): 1726-1728. doi:10.1016/j.ophtha.2017.08.046.
[14] Jiang F, Jiang Y, Zhi H, et al. Artificial intelligence in healthcare: past, present and future[J]. Stroke Vasc Neurol, 2017, 2(4): 230-243. doi:10.1136/svn-2017-000101.
[15] 王丽雯, 崔林, 邹吉新, 等. OCTA在视网膜静脉阻塞诊疗中的应用价值[J]. 国际眼科杂志, 2019, 19(8): 1361-1364. doi:10.3980/j.issn.1672-5123.2019.8.22. WANG Liwen, CUI Lin, ZOU Jixin, et al. Application value of OCTA examination in diagnosis and treatment of retinal vein occlusion[J]. International Eye Science, 2019, 19(8): 1361-1364. doi:10.3980/j.issn.1672-5123.2019.8.22.
[16] Okamoto M, Yamashita M, Sakamoto T, et al. Choroidal blood flow and thickness as predictors for response to anti-vascular endothelial growth factor therapy in macular edema secondary to branch retinal vein occlusion[J]. Retina, 2018, 38(3): 550-558. doi:10.1097/IAE.0000000000001566.
[17] Lee H, Kim MA, Kim HC, et al. Characterization of microvascular tortuosity in retinal vein occlusion utilizing optical coherence tomography angiography[J]. Sci Rep, 2020, 10(1): 17788. doi:10.1038/s41598-020-74871-7.
[18] 金昕, 谭薇, 李燕. 量化OCTA在视网膜静脉阻塞中的应用[J]. 国际眼科杂志, 2021, 21(4): 711-714. doi:10.3980/j.issn.1672-5123.2021.4.30. JIN Xin, TAN Wei, LI Yan. Application of quantitative OCTA in retinal vein occlusion[J]. International Eye Science, 2021, 21(4): 711-714.doi:10.3980/j.issn.1672-5123.2021.4.30.
[1] 朱明琼,李征,刘茹,田涛,彭婧利,吕倩怡,谭华霞. 基于OCT/OCTA的AI筛查系统在抗VEGF治疗糖尿病性黄斑水肿患者效果评价中的应用[J]. 山东大学耳鼻喉眼学报, 2026, 40(1): 68-73.
[2] 孙庆祝,沈健,陈星,吴雁冰,曾论. 代谢指标在预测糖尿病性黄斑水肿患者雷珠单抗疗效中的作用[J]. 山东大学耳鼻喉眼学报, 2026, 40(1): 74-81.
[3] 朱云龙,王平,高萌. 误诊为中浆及视网膜炎的后巩膜炎1例并文献复习[J]. 山东大学耳鼻喉眼学报, 2026, 40(1): 99-105.
[4] 丁术梁,王超凡,刘建亮. 眼内液检测指导精准治疗急性视网膜坏死1例并文献复习[J]. 山东大学耳鼻喉眼学报, 2025, 39(5): 114-117.
[5] 沈嘉琪,李潇飒,毕燕龙,张敬法. 人工智能在DME筛查、诊断和预后中的应用[J]. 山东大学耳鼻喉眼学报, 2024, 38(5): 153-159.
[6] 鲍莹,刘志高,姜鹏飞,崔文轩,郑晓霞,杨梦瑶,司明威,王玉,王红. 康柏西普治疗糖尿病合并CRVO-ME高反射点的临床观察[J]. 山东大学耳鼻喉眼学报, 2024, 38(3): 55-60.
[7] 常威威,焦万珍,崔艳艳,赵杰,刘兆强,赵博军. 糖尿病性黄斑缺血的研究进展[J]. 山东大学耳鼻喉眼学报, 2024, 38(3): 130-136.
[8] 周静琳,李金香,曾琦. 577 nm阈值下微脉冲激光联合抗VEGF药物治疗难治性糖尿病性黄斑水肿的疗效观察[J]. 山东大学耳鼻喉眼学报, 2024, 38(2): 18-25.
[9] 何静,雷春燕,张美霞. 糖化血红蛋白变异指数与糖尿病视网膜病变严重程度的相关性研究[J]. 山东大学耳鼻喉眼学报, 2024, 38(2): 34-40.
[10] 刘天蔚,赵博军. 年轻人群视网膜静脉阻塞研究进展[J]. 山东大学耳鼻喉眼学报, 2024, 38(1): 128-137.
[11] 唐慧新,李景景,邹红. 阈值下微脉冲激光光凝作用机制及临床应用[J]. 山东大学耳鼻喉眼学报, 2023, 37(3): 143-148.
[12] 张陶然,王薇,李明铭,黄映湘. IVR治疗mCNV患者黄斑中心凹下脉络膜厚度分析[J]. 山东大学耳鼻喉眼学报, 2022, 36(2): 68-71.
[13] 韩克阳,于贝贝,赵博军. 短期视网膜静脉阻塞抗VEGF治疗后黄斑区形态结构分析[J]. 山东大学耳鼻喉眼学报, 2019, 33(5): 129-131.
[14] 刘建波,张环. 超声乳化联合玻璃体腔药物注射治疗白内障合并糖尿病性黄斑水肿[J]. 山东大学耳鼻喉眼学报, 2019, 33(2): 99-104.
[15] 梁倩倩,杨庭骅,赵博军. 光学相干层析血管扫描在视网膜静脉阻塞中的应用[J]. 山东大学耳鼻喉眼学报, 2019, 33(2): 139-142.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!
网站版权所有 © 2018 《山东大学耳鼻喉眼学报》编辑部　
地址：山东省济南市山大南路27号（250100）电话：+86-0531-88366912 E-mail: ebhxb@sdu.edu.cn
本系统由北京玛格泰克科技发展有限公司设计开发