Ophthalmologica:地塞米松玻璃体内注射治疗糖尿病性黄斑水肿患者的临床决策

2018-04-08 cuiguizhong MedSci原创

西班牙Clínica纳瓦拉大学的García-Layana A近日在Ophthalmologica发表了一篇文章,他们使用地塞米松作为玻璃体内植入物治疗DME患者,并根据自身经验提出注意事项。

西班牙Clínica纳瓦拉大学的García-Layana A近日在Ophthalmologica发表了一篇文章,他们使用地塞米松作为玻璃体内植入物治疗DME患者,并根据自身经验提出注意事项。

糖尿病(DM)是一种常伴随并发症的代谢性疾病,包括糖尿病性黄斑水肿(DME)。目前治疗DME的医学方法主要包括玻璃体内注射抗血管内皮生长因子或类固醇。然而,玻璃体内注射和DM衍生的并发症负担很高,需要找到最佳的治疗方案。

在本文中,他们描述了使用地塞米松作为玻璃体内植入物(Ozurdex?)治疗DME患者时的注意事项,尤其是对随访期间影响临床决策的因素进行了讨论。这些需要考虑的因素都基于医学文献和研究者在这类患者中使用植入物后的临床经验,目标是优化注射次数和该疗法的临床治疗效果。他们对DME病理生理学的研究进展进行讨论,认为炎症成分是在这些患者中使用类固醇的一个重要原因。

原文出处:

Garcia-Layana, A., et al., Clinical Decision-Making when Treating Diabetic Macular Edema Patients with Dexamethasone Intravitreal Implants. Ophthalmologica, 2018.

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createdBy=810a33379458, createdName=wwzzly, createdTime=Mon Jan 07 17:43:00 CST 2019, time=2019-01-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1745751, encodeId=34651e457515f, content=<a href='/topic/show?id=79ab685899e' target=_blank style='color:#2F92EE;'>#玻璃体内注射#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=68589, encryptionId=79ab685899e, topicName=玻璃体内注射)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=6da635562893, createdName=cathymary, createdTime=Fri Mar 15 15:43:00 CST 2019, time=2019-03-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1333397, encodeId=547a133339eca, content=<a href='/topic/show?id=4ce26423802' target=_blank style='color:#2F92EE;'>#水肿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64238, encryptionId=4ce26423802, topicName=水肿)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKCRibWHQArPHdSkqP90U1HwwqlGeU7BUgzY240D3v2ibBDJ09ybkGkwOjxz7qRmngZaGlK1taX6hfA/132, createdBy=2e772500094, createdName=小华子, createdTime=Tue Apr 10 12:43:00 CST 2018, time=2018-04-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1401427, encodeId=a4a2140142e02, content=<a href='/topic/show?id=a609e6715c6' target=_blank style='color:#2F92EE;'>#糖尿病性黄斑水肿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76715, encryptionId=a609e6715c6, topicName=糖尿病性黄斑水肿)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f5ec2326645, createdName=d830373, createdTime=Tue Apr 10 12:43:00 CST 2018, time=2018-04-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1496225, encodeId=f954149622586, content=<a href='/topic/show?id=bab46858ee3' target=_blank style='color:#2F92EE;'>#玻璃体#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=68587, encryptionId=bab46858ee3, topicName=玻璃体)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Tue Apr 10 12:43:00 CST 2018, time=2018-04-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1510913, encodeId=23e51510913fa, content=<a href='/topic/show?id=abd8103141b8' target=_blank style='color:#2F92EE;'>#黄斑水肿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=103141, encryptionId=abd8103141b8, topicName=黄斑水肿)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9a10269982, createdName=xiay994456, createdTime=Tue Apr 10 12:43:00 CST 2018, time=2018-04-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1525129, encodeId=0ccd15251295a, content=<a href='/topic/show?id=65e91031337f' target=_blank style='color:#2F92EE;'>#黄斑#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=103133, encryptionId=65e91031337f, topicName=黄斑)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=638b11619344, createdName=muzishouyi, createdTime=Tue Apr 10 12:43:00 CST 2018, time=2018-04-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1541335, encodeId=fdf315413359b, content=<a href='/topic/show?id=5c961e37307' target=_blank style='color:#2F92EE;'>#THA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17373, encryptionId=5c961e37307, topicName=THA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=615b13300589, createdName=1249842em13(暂无昵称), createdTime=Tue Apr 10 12:43:00 CST 2018, time=2018-04-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1541819, encodeId=70241541819c4, content=<a href='/topic/show?id=e8ca3108823' target=_blank style='color:#2F92EE;'>#决策#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31088, encryptionId=e8ca3108823, topicName=决策)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e76e13331157, createdName=ms2999106592497887, createdTime=Tue Apr 10 12:43:00 CST 2018, time=2018-04-10, status=1, ipAttribution=)]
    2018-04-10 小华子
  5. [GetPortalCommentsPageByObjectIdResponse(id=2053641, encodeId=f5c42053641f5, content=<a href='/topic/show?id=e8646858880' target=_blank style='color:#2F92EE;'>#玻璃体内#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=68588, encryptionId=e8646858880, topicName=玻璃体内)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=05a2499, createdName=dzx0922889, createdTime=Sun Dec 30 16:43:00 CST 2018, time=2018-12-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1723208, encodeId=122a1e2320805, content=<a href='/topic/show?id=ab292269213' target=_blank style='color:#2F92EE;'>#临床决策#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22692, encryptionId=ab292269213, topicName=临床决策)], attachment=null, authenticateStatus=null, createdAvatar=null, 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topicList=[TopicDto(id=64238, encryptionId=4ce26423802, topicName=水肿)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKCRibWHQArPHdSkqP90U1HwwqlGeU7BUgzY240D3v2ibBDJ09ybkGkwOjxz7qRmngZaGlK1taX6hfA/132, createdBy=2e772500094, createdName=小华子, createdTime=Tue Apr 10 12:43:00 CST 2018, time=2018-04-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1401427, encodeId=a4a2140142e02, content=<a href='/topic/show?id=a609e6715c6' target=_blank style='color:#2F92EE;'>#糖尿病性黄斑水肿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76715, encryptionId=a609e6715c6, topicName=糖尿病性黄斑水肿)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f5ec2326645, createdName=d830373, createdTime=Tue Apr 10 12:43:00 CST 2018, time=2018-04-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1496225, encodeId=f954149622586, content=<a href='/topic/show?id=bab46858ee3' target=_blank style='color:#2F92EE;'>#玻璃体#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=68587, encryptionId=bab46858ee3, topicName=玻璃体)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Tue Apr 10 12:43:00 CST 2018, time=2018-04-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1510913, encodeId=23e51510913fa, content=<a href='/topic/show?id=abd8103141b8' target=_blank style='color:#2F92EE;'>#黄斑水肿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=103141, encryptionId=abd8103141b8, topicName=黄斑水肿)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9a10269982, createdName=xiay994456, createdTime=Tue Apr 10 12:43:00 CST 2018, time=2018-04-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1525129, encodeId=0ccd15251295a, content=<a href='/topic/show?id=65e91031337f' target=_blank style='color:#2F92EE;'>#黄斑#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=103133, encryptionId=65e91031337f, topicName=黄斑)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=638b11619344, createdName=muzishouyi, createdTime=Tue Apr 10 12:43:00 CST 2018, time=2018-04-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1541335, encodeId=fdf315413359b, content=<a href='/topic/show?id=5c961e37307' target=_blank style='color:#2F92EE;'>#THA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17373, encryptionId=5c961e37307, topicName=THA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=615b13300589, createdName=1249842em13(暂无昵称), createdTime=Tue Apr 10 12:43:00 CST 2018, time=2018-04-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1541819, encodeId=70241541819c4, content=<a href='/topic/show?id=e8ca3108823' target=_blank style='color:#2F92EE;'>#决策#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31088, encryptionId=e8ca3108823, topicName=决策)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e76e13331157, createdName=ms2999106592497887, createdTime=Tue Apr 10 12:43:00 CST 2018, time=2018-04-10, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=2053641, encodeId=f5c42053641f5, content=<a href='/topic/show?id=e8646858880' target=_blank style='color:#2F92EE;'>#玻璃体内#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=68588, encryptionId=e8646858880, topicName=玻璃体内)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=05a2499, createdName=dzx0922889, createdTime=Sun Dec 30 16:43:00 CST 2018, time=2018-12-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1723208, encodeId=122a1e2320805, content=<a href='/topic/show?id=ab292269213' target=_blank style='color:#2F92EE;'>#临床决策#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22692, encryptionId=ab292269213, topicName=临床决策)], attachment=null, authenticateStatus=null, createdAvatar=null, 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encodeId=f954149622586, content=<a href='/topic/show?id=bab46858ee3' target=_blank style='color:#2F92EE;'>#玻璃体#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=68587, encryptionId=bab46858ee3, topicName=玻璃体)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Tue Apr 10 12:43:00 CST 2018, time=2018-04-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1510913, encodeId=23e51510913fa, content=<a href='/topic/show?id=abd8103141b8' target=_blank style='color:#2F92EE;'>#黄斑水肿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=103141, encryptionId=abd8103141b8, topicName=黄斑水肿)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9a10269982, createdName=xiay994456, createdTime=Tue Apr 10 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attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=615b13300589, createdName=1249842em13(暂无昵称), createdTime=Tue Apr 10 12:43:00 CST 2018, time=2018-04-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1541819, encodeId=70241541819c4, content=<a href='/topic/show?id=e8ca3108823' target=_blank style='color:#2F92EE;'>#决策#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31088, encryptionId=e8ca3108823, topicName=决策)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e76e13331157, createdName=ms2999106592497887, createdTime=Tue Apr 10 12:43:00 CST 2018, time=2018-04-10, status=1, ipAttribution=)]
  7. [GetPortalCommentsPageByObjectIdResponse(id=2053641, encodeId=f5c42053641f5, content=<a href='/topic/show?id=e8646858880' target=_blank style='color:#2F92EE;'>#玻璃体内#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=68588, encryptionId=e8646858880, topicName=玻璃体内)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=05a2499, createdName=dzx0922889, createdTime=Sun Dec 30 16:43:00 CST 2018, time=2018-12-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1723208, encodeId=122a1e2320805, content=<a href='/topic/show?id=ab292269213' target=_blank style='color:#2F92EE;'>#临床决策#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22692, encryptionId=ab292269213, topicName=临床决策)], attachment=null, authenticateStatus=null, createdAvatar=null, 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12:43:00 CST 2018, time=2018-04-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1525129, encodeId=0ccd15251295a, content=<a href='/topic/show?id=65e91031337f' target=_blank style='color:#2F92EE;'>#黄斑#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=103133, encryptionId=65e91031337f, topicName=黄斑)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=638b11619344, createdName=muzishouyi, createdTime=Tue Apr 10 12:43:00 CST 2018, time=2018-04-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1541335, encodeId=fdf315413359b, content=<a href='/topic/show?id=5c961e37307' target=_blank style='color:#2F92EE;'>#THA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17373, encryptionId=5c961e37307, topicName=THA)], 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  8. [GetPortalCommentsPageByObjectIdResponse(id=2053641, encodeId=f5c42053641f5, content=<a href='/topic/show?id=e8646858880' target=_blank style='color:#2F92EE;'>#玻璃体内#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=68588, encryptionId=e8646858880, topicName=玻璃体内)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=05a2499, createdName=dzx0922889, createdTime=Sun Dec 30 16:43:00 CST 2018, time=2018-12-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1723208, encodeId=122a1e2320805, content=<a href='/topic/show?id=ab292269213' target=_blank style='color:#2F92EE;'>#临床决策#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22692, encryptionId=ab292269213, topicName=临床决策)], attachment=null, authenticateStatus=null, createdAvatar=null, 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12:43:00 CST 2018, time=2018-04-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1525129, encodeId=0ccd15251295a, content=<a href='/topic/show?id=65e91031337f' target=_blank style='color:#2F92EE;'>#黄斑#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=103133, encryptionId=65e91031337f, topicName=黄斑)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=638b11619344, createdName=muzishouyi, createdTime=Tue Apr 10 12:43:00 CST 2018, time=2018-04-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1541335, encodeId=fdf315413359b, content=<a href='/topic/show?id=5c961e37307' target=_blank style='color:#2F92EE;'>#THA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17373, encryptionId=5c961e37307, topicName=THA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=615b13300589, createdName=1249842em13(暂无昵称), createdTime=Tue Apr 10 12:43:00 CST 2018, time=2018-04-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1541819, encodeId=70241541819c4, content=<a href='/topic/show?id=e8ca3108823' target=_blank style='color:#2F92EE;'>#决策#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31088, encryptionId=e8ca3108823, topicName=决策)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e76e13331157, createdName=ms2999106592497887, createdTime=Tue Apr 10 12:43:00 CST 2018, time=2018-04-10, status=1, ipAttribution=)]
    2018-04-10 muzishouyi
  9. 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  10. 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J Clin Anesth:静脉注射地塞米松作为改善分娩镇痛的辅助:随机、双盲、安慰剂对照试验

研究静脉注射(i.v.)地塞米松作为辅助分娩镇痛中的作用。

地塞米松在门诊常见用法汇总

为减轻体液潴留,除有禁忌外,所有病人在接受泰索帝(多西他赛)治疗前均必须预服药物。此类药物只能包括口服糖皮质激素类,如地塞米松,在泰索帝(多西他赛)滴注一天前服用,每天16mg(例如:每日2次,每次8mg),持续3天。(来源于CFDA说明书)

EUR J Cancer:使用环磷酰胺 - 硼替佐米 - 地塞米松治疗原发性轻链型心脏淀粉样变性中地塞米松的心脏毒性

非骨髓瘤浆细胞恶液质疾病泛指骨髓瘤以外因浆细胞增生所产生的病症。包括单克隆伽玛球蛋白症(monoclonal gammopathy of undeterminated significance;MGUS),轻链型淀粉样变性(light-chain related amyloidosis),冷凝球蛋白血症(cryoglobulinemia)等。

Retina: 玻璃体腔内注射地塞米松的位置与眼高压相关性研究

印度巴罗达Sudhalkar眼科医院和视网膜中心的Sudhalkar A近日在Retina杂志上发表了他们近期的一项工作,他们研究了玻璃体腔内注射地塞米松的位置与眼高压(OHT)之间的关系。

Iran J Otorhinolaryngol:突发性感官听力损失中鼓膜内地塞米松-透明质酸治疗作用分析

听力损失是一种常见的疾病,通常通过全身用药和/或者鼓膜内注射皮质类固醇来进行治疗。最近,有研究人员比较了鼓膜内注射地塞米松以及与透明质酸结合注射时,对突发性感官听力损失病人的治疗效应。在该次临床实践中,40名病人被随机分配到2个组;在第一个小组中,20名病人接受2.4毫克鼓膜内地塞米松注射,然而在第二小组中,病人接受2.4毫克地塞米松和2毫克透明质酸组合注射。两个小组的病人每隔一天进行一次注射,总

SJA:度洛西汀和地塞米松改善腹腔镜妇科手术术后疼痛:随机临床试验

患者的手术体验,受到痛苦管理观念的影响。 度洛西汀(Dulox)和地塞米松(Dex)可用于多模式镇痛以减少阿片类药物的使用和副作用。 Dulox是一种选择性5-羟色胺和去甲肾上腺素再摄取抑制剂,对慢性疼痛有效。 Dex增强术后镇痛并减少术后恶心呕吐(PONV)。