玻璃体腔注射雷珠单抗与康柏西普治疗早产儿视网膜病变疗效比较

Comparison of intravitreal injection of Ranibizumab versus Conbercept in the treatment of retinopathy of prematurity

摘要:

目的：比较早产儿视网膜病变(ROP)患儿采用玻璃体腔注射雷珠单抗(IVR)与康柏西普(IVC)两种药物的治疗效果。

方法：回顾性研究。纳入我院2015-01/2023-06玻璃体腔注射抗VEGF药物治疗的ROP患眼1 100眼。根据治疗药物的不同，将患儿分为IVR组和IVC组。根据ROP的病变程度分为急进型ROP(A-ROP)、Ⅰ区1型ROP和Ⅱ区1型ROP。通过倾向性匹配分析(PSM)匹配后对两组复活与再次治疗情况进行比较。随访时间至少至术后3 mo。

结果：在Ⅱ区1型ROP中，IVR组和IVC组的病变复活率及再次治疗率均有差异(P<0.05)； A-ROP和Ⅰ区1型ROP中两组病变复活率及再次治疗率均无差异(P>0.05)。Ⅰ区1型ROP复活风险及再次治疗风险高于Ⅱ区1型ROP，药物的选择和首次治疗矫正胎龄是术后病变复活及再次治疗的影响因素。

结论：玻璃体腔注射IVR或IVC对Ⅱ区1型ROP的首次治愈效果有明显差异，且IVC组的复活率和再次治疗率远低于IVR组。

Abstract:

AIM: To compare the efficacy of intravitreal injection of ranibizumab(IVR)and intravitreal injection of conbercept(IVC)in children with retinopathy of prematurity(ROP).

METHODS: Retrospective study. A total of 1 100 eyes with ROP treated with intravitreal anti-VEGF at our hospital from January 2015 to June 2023 were included. According to the different therapeutic drugs, the children were divided into two groups: IVR group and IVC group. According to the degree of ROP, the patients were divided into three groups: aggressive ROP(A-ROP), Zone Ⅰ type 1 ROP and Zone Ⅱ type 1 ROP. The reactivation and retreatment between the two groups were compared after propensity score matching(PSM)analysis, and they were followed-up for at least 3 mo after surgery.

RESULTS: In Zone Ⅱ type 1 ROP, there was a statistically significant difference in the rates of reactivation and retreatment between the IVR and IVC groups(P<0.05); however, in A-ROP and Zone I type 1 ROP, there were no statistically significant differences in the rates of reactivation and retreatment between the two groups(P>0.05). The risk of reactivation and retreatment of Zone I type 1 ROP was higher than the Zone II type 1 ROP. Furthermore, the use of drugs and corrected gestational age of first treatment were influencing factors of lesion recurrence and retreatment.

CONCLUSION: There is a significant difference in the initial cure effect between the two drugs in Zone II type 1 ROP, with the reactivation and retreatment rates of the IVC group being much lower than those of the IVR group.