目的：探讨PDR患者行玻璃体切割术(PPV)前玻璃体内注射雷珠单抗对手术效果、并发症的影响。

方法：选取我院2016-01/2018-01拟实施PPV手术的患者84例106眼，采用随机数字表法分为观察组和对照组，各42例，两组均采用PPV手术治疗，观察组术前给予雷珠单抗玻璃体注射治疗。对比两组患者手术前后的BCVA、黄斑中心凹厚度、血清VEGF、人生长停滞特异性蛋白6(GAS6)、人基质细胞衍生因子-1(SDF-1)、手术并发症。

结果：术前两组BCVA无差异(P>0.05)； 术后3mo，观察组的BCVA显著优于对照组(P<0.05)。术后1wk，观察组的黄斑中心凹厚度小于对照组(P<0.05)； 术后3mo，两组的黄斑中心凹厚度无差异(P>0.05)。术前两组患者的血清VEGF、GAS6、SDF-1水平无差异(P<0.05)； 术后1wk，观察组的血清VEGF、GAS6、SDF-1水平低于对照组(P<0.05)。观察组的并发症率低于对照组(5.9% vs 20.0%，P<0.05)。

结论：PDR患者行PPV前玻璃体内注射雷珠单抗能显著地降低黄斑厚度、血清VEGF、GAS6、SDF-1水平，提升手术后的视力，降低手术并发症发生率。

METHODS: We selected 84 patients with 106 eyes who were scheduled to undergo PPV surgery in our hospital from 01-2016/01-2018. According to the random number table method, the observation group and the control group were divided into 42 cases. Both groups were treated with PPV surgery, and the observation group was given a vitreous injection of ranibizumab before surgery. The BCVA, macular foveal thickness, serum VEGF, GAS6, SDF-1, and surgical complications were compared between the two groups before and after surgery.

RESULTS: There was no difference in BCVA between the two groups before operation(P>0.05). At 3mo after operation, the BCVA of the observation group was significantly better than that of the control group(P<0.05). At 1wk postoperatively, the foveal thickness of the observation group was smaller than that of the control group(P<0.05). At 3mo after operation, there was no difference in the thickness of the foveal fove between the two groups(P>0.05). There were no differences in serum VEGF, GAS6 and SDF-1 levels between the two groups before surgery(P<0.05). At 1wk postoperatively, the serum levels of VEGF, GAS6 and SDF-1 in the observation group were lower than those in the control group(P<0.05). The complication rate of the observation group was lower than that of the control group(5.9% vs 20.0%, P<0.05).

CONCLUSION: Intravitreal injection of ranibizumab in patients with PDR can significantly reduce macular thickness, serum VEGF, GAS6, and SDF-1 levels, improve visual acuity after surgery, and reduce the incidence of surgical complications.