【摘要】 目的 探讨雷珠单抗联合810nm激光治疗新生血管性青光眼临床疗效及对患者血流动力学、疾病预后的影响。方法 应用电脑随机数字表和单盲法将81例新生血管性青光眼患者分为激光组（41例）、联合组（40例）。激光组给予810nm激光治疗，联合组给予雷珠单抗联合810nm激光治疗，观察1个月，术后随访3个月。比较治疗前和治疗后1个月两组视力、眼压、眼血流动力学（睫状后短动脉、视网膜中央动脉、眼动脉最大收缩期血流峰值速度、阻力指数）、房水中新生血管因子（血小板源性生长因子-C、血管内皮生长因子、血小板反应蛋白-1）水平、安全性及预后情况。结果 治疗后1个月联合组视力水平优于激光组，视力改善率高于激光组，差异有统计学意义（P<0.01）。治疗后1个月联合组眼压低于激光组，绝对治愈率高于激光组，差异有统计学意义（P<0.01）。治疗后1个月联合组睫状后短动脉、眼动脉最大收缩期血流峰值速度及睫状后短动脉、眼动脉、视网膜中央动脉阻力指数低于激光组，差异有统计学意义（P<0.01）。治疗1个月联合组血小板源性生长因子-C、血管内皮生长因子水平低于激光组，血小板反应蛋白-1水平高于激光组，差异有统计学意义（P<0.01）。联合组不良反应发生率为1 7.50%，激光组为14.63%，两组比较差异无统计学意义（P>0.05）。随访3个月联合组眼压再次升高率为2.50%，激光组为19.51%，两组比较差异有统计学意义（P<0.05）。结论 雷珠单抗联合810nm激光治疗新生血管性青光眼效果可靠，可降低患者眼压，促进视力好转，改善眼血流动力学，且安全有效，预后良好。更多还原

【Abstract】 Objective To explore clinical effects of ranibizumab plus 810nm laser in the treatment of neovascular glaucoma(NVG)and its influences on hemodynamics and prognosis.Methods Eighty-one NVG patients were assigned to laser(n=41)and combination(n=40)group using computer random number table and single-blind method.Laser group received 810nm laser treatment,the combination did ranibizumab plus 810nm laser,they were observed for 1month,and followed up for 3months.Such indexes were compared between two groups before treatment and in post-treatment 1month as vision,intraocular pressure(IOP),ocular hemodynamics,neovascular factor levels in aqueous humor,safety and prognosis.Results In 1month after treatment the visual acuity levels were better and improvement rate of visual acuity was higher in combination than in laser group,differences were statistically significant(P<0.01).In1month after treatment the IOPs were lower and absolute cure rate was higher in combination than in laser group,differences were statistically significant(P<0.01).In 1month after treatment the peak systolic velocities of short posterior ciliary artery and ophthalmic artery and the resistance indice of short posterior ciliary artery,ophthalmic artery and central retinal artery were lower in combination than in laser group,differences were statistically significant(P<0.01).In 1 month after treatment platelet derived growth factor-C and vascular endothelial growth factor levels were lower and thrombospondin-1higher in combination than in laser group,differences were statistically significant(P<0.01).The incidence of adverse reactions was 17.50%in combination and 14.63%in laser group,the difference was not statistically significant(P>0.05);during the 3-month follow-up the re-increase rate of intraocular pressure was lower in combination than in laser group(2.50% vs.19.51%),the difference was statistically significant(P<0.05).Conclusion Ranibizumab plus 810nm laser has a reliable effect in the treatment of the NVG,could reduce intraocular pressure,improve vision and ocular hemodynamics,is safe,and has favourable prognosis.更多还原