复方血栓通片联合雷珠单抗治疗湿性年龄相关性黄斑变性患者的疗效分析

The effect of compound Xueshuantong tablets combined with ranibizumab on the thickness of the retina in patients withwet age-related macular degeneration

摘要:

目的 探讨湿性年龄相关性黄斑变性（ARMD）患者应用复方血栓通片联合雷珠单抗治疗的临床疗效及其对视网膜厚度的影响。方法 选取2018年5月—2019年12月浙江省舟山医院收治的湿性ARMD患者120例（152眼），根据随机数字表法分为观察组和对照组，每组60例（76眼）。对照组患者给予玻璃体腔注射雷珠单抗治疗，观察组患者在对照组基础上口服复方血栓通片。比较两组患者治疗前、治疗后1个月和3个月的最佳矫正视力（BCVA）、视网膜电图（ERG）、眼血流动力学、视网膜黄斑中心凹厚度（CMT），以及治疗后并发症和复发情况。结果 观察组与对照组在治疗前、治疗后1个月和3个月的BCVA、ERG（a波振幅、b波振幅、a波潜伏时间、b波潜伏时间）、眼血流动力学（PSV、EDV、RI）及CMT比较，在不同时间、不同组间有差异（P <0.05）；但变化趋势无差异（P >0.05）。两组患者并发症发生率比较，差异无统计学意义（P >0.05）。观察组患者复发率（11.43%）低于对照组（31.88%）（P <0.05）。结论 复方血栓通片联合雷珠单抗治疗湿性ARMD，能够促进黄斑区沉积物的吸收，降低CMT厚度，提高患者视力，临床疗效显著，值得推广。

Abstract:

Objective To investigate the clinical efficacy of compound Xueshuantong tablets combined with ranibizumab in patients with wet age-related macular degeneration and the effects on retinal thickness.Methods A total of 120 wet age-related macular degeneration patients (152 eyes) who were admitted to the Eye Center of Zhoushan Hospital of Zhejiang Province from May 2018 to December 2019 were selected and divided into observation group and control group, with 60 cases (76 eyes) in each group according to the random number table method. Patients in the control group were treated with intravitreal injection of ranibizumab, and patients in the observation group were treated with compound Xueshuantong tablets on the basis of the control group. We then observed and compared the best corrected visual acuity (BCVA), electroretinogram (ERG), ocular hemodynamics, and central macular thickness (CMT) of the two groups of patients 1 day before treatment and 1 month and 3 months after treatment. The complications and recurrence after treatment were also compared between the two groups.Results The BCVA, ERG (a wave amplitude, b wave amplitude, a wave latency, b wave latency), ocular hemodynamics [peak systolic velocity (PSV), end diastolic velocity (EDV), resistivity index (RI)] and CMT were different among different time points and between the groups (P < 0.05), but there was no difference in the trend of change of these indicators (P > 0.05). No significant difference was observed in the incidence of complications between the two groups (P > 0.05). The recurrence rate of the observation group (11.43%) was significantly lower than that of the control group (31.88%) (P < 0.05).Conclusions Compound Xueshuantong tablets combined with ranibizumab can promote the absorption of deposits in the macular area, reduce the CMT, and improve the vision of patients with wet age-related macular degeneration, which exhibits a significant clinical effect and is worthy of further application.