目的 分析康柏西普和曲安奈德治療非動(dòng)脈炎性前部缺血性視神經(jīng)病變患者的臨床療效。方法 選取2017年9月—2019年1月濮陽市眼科醫(yī)院收治的非動(dòng)脈炎性前部缺血性視神經(jīng)病變患者80例，隨機(jī)分為對(duì)照組（40例）和治療組（40例）。對(duì)照組注射醋酸曲安奈德注射液，4 mg/次。治療組注射康柏西普眼用注射液，0.05 mL/（眼·次）。比較治療前后兩組患者視力和視野調(diào)查結(jié)果，眼壓、神經(jīng)纖維層厚度和視盤水腫消退時(shí)間，及玻璃體液中血管內(nèi)皮生長因子-A（VEGF-A）水平。結(jié)果 治療后，對(duì)照組視力和視野總有效率分別為80.00%和90.00%，均顯著低于治療組的95.00%和100.00%，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組患者眼壓及神經(jīng)纖維層厚度均明顯降低（P<0.05），且治療組患者眼壓、神經(jīng)纖維層厚度、視盤水腫消退時(shí)間均明顯低于對(duì)照組（P<0.05）。最后1次治療時(shí)，兩組患者玻璃體腔中VEGF-A水平均明顯降低（P<0.05），且治療組明顯低于對(duì)照組（P<0.05）。結(jié)論 玻璃體腔注射康柏西普可顯著提高非動(dòng)脈炎性前部缺血性視神經(jīng)病變患者的視力和視野，有效改善治療臨床療效。

Objective To analyze the clinical efficacy of intravitreal injection of conbercept and triamcinolone in treatment of non-arteritic anterior ischemic optic neuropathy. Methods Patients (80 cases) with non-arteritic anterior ischemic optic neuropathy in Puyang Eye Hospital from September 2017 to January 2019 were randomly divided into control (40 cases) and treatment (40 cases) groups. Patients in the control group were intravitreal administered with Triamcinolone Acetonide Acetate Injection, 4 mg/time. Patients in the treatment group were intravitreal administered with Conbercept Ophthalmic Injection, 0.05 mL/(eye∙time). After treatment, treatment results of visual acuity and visual field, intraocular pressure, the thickness of nerve fiber layer, the extinction time of optic disc edema, the VEGF-A level in vitreous humor in two groups before and after treatment were compared. Results After treatment, the efficiency of visual acuity and field in the control group were 80.00% and 90.00%, which were significantly lower than 95.00% and 100.00% in the treatment group, respectively, and there were differences between two groups (P<0.05). After treatment, the intraocular pressure and the thickness of nerve fiber layer in two groups were significantly decreased (P<0.05), and the intraocular pressure, the thickness of nerve fiber layer, the extinction time of optic disc edema in the treatment group were significantly lower than those in the control group (P<0.05). After treatment, the VEGF-A level in vitreous humor in two groups was significantly decreased (P<0.05), and which in the treatment group was significantly lower than that in the control group (P<0.05). Conclusions The intravitreal injection of conbercept can significantly improve the vision and visual field of patients with non-arteritic anterior ischemic optic neuropathy, and effectively improve the clinical efficacy.

R988.1

江西省衛(wèi)生計(jì)生委科技計(jì)劃資助項(xiàng)目（20187236）