目的 探讨雷珠单抗与长春胺联合治疗缺血性视网膜静脉阻塞的临床疗效。方法 选择2020年5月—2022年5月商丘第一人民医院收治的80例缺血性视网膜静脉阻塞患者，按照随机数字表法分为对照组和治疗组，每组各40例。对照组患者口服长春胺缓释胶囊，1粒/次，2次/d。在对照组的基础上，治疗组经玻璃体内注射雷珠单抗注射液，0.5mg/次，1次/月。两组用药12周。观察两组患者临床疗效，比较治疗前后两组患者症状缓解时间，视力与视野相关指标，视盘周围神经厚度和视网膜神经节细胞复合体厚度，血清肿瘤坏死因子-α（TNF-α）、血管内皮生长因子（VEGF）、C反应蛋白（CRP）和白细胞介素-6（IL-6）水平，及不良反应。结果 治疗后，治疗组总有效率为97.50%，明显高于对照组（77.50%，P＜0.05）。治疗后，治疗组患者症状缓解时间均明显早于低于对照组（P＜0.05）。治疗后，两组平均视力、平均光敏感度指标均升高，而视野平均偏差、视野校正形态标准差指标均降低（P＜0.05）；且治疗组视力与视野相关指标改善优于对照组（P＜0.05）。治疗后，两组视盘周围神经厚度、视网膜神经节细胞复合体厚度指标均下降（P＜0.05）；且治疗组的视盘周围神经厚度、视网膜神经节细胞复合体厚度指标均低于对照组（P＜0.05）。治疗后，两组血清因子白细胞介素-6（IL-6）、血管内皮生长因子（VEGF）、肿瘤坏死因子-α（TNF-α）、C反应蛋白（CRP）水平均降低（P＜0.05）；且治疗后治疗组IL-6、VEGF、TNF-α、CRP水平均低于对照组（P＜0.05）。治疗组不良反应发生率明显低于对照组（P＜0.05）。结论 长春胺缓释胶囊与雷珠单抗注射液联合治疗效果确切，症状得到有效缓解，视力及光敏感程度有效改善，并能降低炎性反应，且安全性良好。

Objective To investigate the clinical effect of ranibizumab combined with vincamine in treatment of ischemic retinal vein occlusion. Methods Patients (80 cases) with ischemic retinal vein occlusion in First People's Hospital of Shangqiu from May 2020 to May 2022 were randomly divided into control and treatment group, and each group had 40 cases. Patients in the control group were po administered with Vincamine Sustained Release Capsules, 1 grain/time, twice daily. Patients in the treatment group received intravitreal injection of Ranibizumab Injections on the basis of the control group, 0.5 mg/time, once monthly. Patients in two groups were treated for 12 weeks. After treatment, the clinical evaluation was evaluated, the improvement time of symptom, visual acuity and visual field related indicators, thickness of peripheral optic nerve and retinal ganglion cell complex, levels of serum IL-6, VEGF, TNF-α and CRP, adverse incidence in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group was 97.50%, which was significantly higher than that of the control group (77.50%, P<0.05). After treatment, the time of symptom relief in the treatment group was significantly earlier than that in the control group (P<0.05). After treatment, the average visual acuity and average light sensitivity indexes were increased, but the average deviation of visual field and the standard deviation of visual field correction were decreased in both groups (P<0.05). The improvement of visual acuity and visual field related indexes in the treatment group was better than that in the control group (P<0.05). After treatment, the thickness indexes of perioptic nerve and retinal ganglion cell complex decreased in both groups (P<0.05). The thickness of perioptic nerve and retinal ganglion cell complex in treatment group were lower than those in control group (P<0.05). After treatment, the serum levels of interleukin-6 (IL-6), vascular endothelial growth factor (VEGF), tumor necrosis factor-α (TNF-α) and C-reactive protein (CRP) were decreased in both groups (P<0.05). After treatment, the levels of IL-6, VEGF, TNF-α and CRP in treatment group were lower than those in control group (P<0.05). The incidence of adverse reactions in the treatment group was significantly lower than that in the control group (P<0.05). Conclusion Ranibizumab combined with vincamine in treatment of ischemic retinal vein occlusion have definite therapeutic effects, the symptoms can be effectively relieved, vision and light sensitivity can be effectively improved, and inflammatory reaction can be reduced, and the safety is good.

R988.1

河南省医学科技攻关计划项目（2018020945）