目的：探讨湿性年龄相关性黄斑变性(wAMD)患者采用雷珠单抗联合光动力疗法的临床效果及对患者血清新生血管调控因子的影响。

方法：回顾性分析。选取2014-01/2016-06我院治疗的wAMD患者68例68眼进行分析，其中采取光动力疗法治疗(对照组)34眼、采用雷珠单抗联合光动力疗法治疗(治疗组)34眼，对比两组患者治疗前后BCVA、视网膜平均厚度、黄斑中心凹视网膜厚度(CMT)值及血清新生血管调控因子情况。

结果：治疗前，两组患者的BCVA、视网膜平均厚度、CMT值比较差异无统计学意义(P>0.05)； 治疗后3、6、12mo，两组患者的BCVA值、视网膜平均厚度、CMT值较本组治疗前均显著降低，差异有统计学意义(P<0.05)； 治疗组患者的BCVA值、视网膜平均厚度、CMT值均显著低于对照组，差异有统计学意义(P<0.05)。治疗前，两组患者血清中VEGF、PDGF、TIMP-1、ES值差异无统计学意义(P>0.05)； 治疗后3mo，两组患者血清中的VEGF、PDGF、ES值较本组治疗前均显著降低，差异有统计学意义(P<0.05)； 治疗组患者的VEGF、PDGF、ES值均显著低于对照组，差异有统计学意义(P<0.05)。

结论：雷珠单抗联合光动力疗法治疗wAMD患者能取得更加显著的临床效果，更有效地降低血清中新生血管调控因子水平。

METHODS: Totally 68 cases(68 eyes)of wAMD patients treated with PDT in our hospital from January 2014 to June 2016 were analyzed retrospectively. Among them, 34 patients were treated by photodynamic therapy(control group)and 34 patients were treated by combination of photodynamic therapy and ranibizumab(treatment group). Comparison of BCVA, mean retinal thickness and central macular thickness(CMT)and serum neovascularization regulatory factors before and after treatment were taken between the two groups.

RESULTS: Before treatment, there was no significant difference on the BCVA, the average retinal thickness and the CMT value between the two groups(P>0.05). At 3, 6 and 12mo after treatment, the BCVA, average retinal thickness and CMT in both groups were significantly lower than those before treatment(P<0.05). At 3, 6 and 12mo after treatment, the BCVA, the average retinal thickness and the CMT value of the patients in the treatment group were significantly lower than those in the control group(P<0.05). There was no significant difference of vascular endothelial growth factor(VEGF), platelet derived growth factor(PDGF), matrix metallo-proteinase inhibitor(TIMP)-1 and endostatin(ES)between the two groups before treatment(P>0.05). Three months after treatment, VEGF, PDGF and ES in both groups were significantly lower than those before treatment(P<0.05). Three months after treatment, the levels of VEGF, PDGF and ES in the treatment group were significantly lower than those in the control group(P<0.05).

CONCLUSION: The wAMD patients treated with ranibizumab combined with photodynamic therapy can achieve a more significant clinical effect, and more effectively reduce the level of serum neovascularization regulators.