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巴西一家高复杂度公立医院接受玻璃体腔内抗血管生成药物治疗的患者情况分析。

Profile of patients treated with intravitreal antiangiogenics in a Brazilian public service with high level of complexity.

机构信息

Serviço de Oftalmologia, Hospital das Clínicas, Universidade Estadual de Campinas, Campinas, SP, Brazil.

出版信息

Arq Bras Oftalmol. 2023 Apr 17;87(5):e20220119. doi: 10.5935/0004-2749.2022-0119. eCollection 2023.

Abstract

PURPOSE

Intravitreal antiangiogenic therapy is currently the most invasive ophthalmic procedure performed worldwide. This study aimed to describe the clinical and epidemiological profile of patients undergoing intravitreal antiangiogenic therapy in a tertiary referral hospital in Brazil.

METHODS

This cross-sectional, retrospective, and observational study analyzed medical records of patients who received intravitreal injections of antiangiogenic agents for the treatment of retinal diseases at the ophthalmology outpatient clinic in the Hospital das Clínicas at Unicamp between January and December 2020.

RESULTS

The study included 429 patients and 514 eyes. The study population was predominantly male (51.28%), white (80.89%), between 50 and 80 years old (mean age, 60.92 years), had complete or incomplete first-grade education (56.88%), and did not belong to the Regional Health Department of which Campinas is a part (78.55%). Bevacizumab was the most commonly used intravitreal injectable medicine (79.38%), pro re nata was the most commonly used treatment regimen (90.27%), and macular edema was the most prevalent pathology indicative of treatment (60.12%), with diabetes etiology accounting for 48.25%. The average number of injections per patient was 3.83, with the macular neovascularization group and the pro re nata group having the highest and lowest with five and three injections, respectively. Treatment adherence was associated with the patient's pathology, and the macular edema (52.24%) and macular neovascularization (49.48%) groups had the lowest adherence rates.

CONCLUSIONS

This study evaluated the epidemiological and clinical profile of patients undergoing antiangiogenic therapy in a high-complexity public hospital, which is fundamental for a better understanding of the demand for ophthalmic reference service in Brazil, and the analysis of functional results and user adherence profile promotes optimization of indications and leverages the benefits of intravitreal therapy.

摘要

目的

玻璃体内抗血管生成治疗目前是全球开展最多的眼科侵袭性操作。本研究旨在描述巴西一家三级转诊医院接受玻璃体内抗血管生成治疗的患者的临床和流行病学特征。

方法

这是一项横断面、回顾性和观察性研究,分析了 2020 年 1 月至 12 月期间在坎皮纳斯大学附属医院眼科门诊接受玻璃体内抗血管生成药物注射治疗视网膜疾病的患者的病历。

结果

本研究纳入了 429 名患者和 514 只眼。研究人群主要为男性(51.28%)、白人(80.89%)、50 至 80 岁(平均年龄 60.92 岁)、具有完整或不完整的初中学历(56.88%)、不属于坎皮纳斯所在的地区卫生部门(78.55%)。贝伐单抗是最常用的玻璃体内注射药物(79.38%),pro re nata 是最常用的治疗方案(90.27%),最常见的治疗指征是黄斑水肿(60.12%),病因是糖尿病的占 48.25%。每位患者的平均注射次数为 3.83 次,其中黄斑新生血管组和 pro re nata 组的注射次数最高和最低,分别为 5 次和 3 次。治疗依从性与患者的病理状况相关,黄斑水肿(52.24%)和黄斑新生血管(49.48%)组的依从性最低。

结论

本研究评估了高复杂性公立医院中接受抗血管生成治疗患者的流行病学和临床特征,这对于更好地了解巴西眼科参考服务的需求至关重要,对功能结果和使用者依从性特征的分析可优化适应证并发挥玻璃体内治疗的益处。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/96c6/11623446/649f0616b9f0/abo-87-05-e2022-0119-g01.jpg

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