基于证据的指导方针,用于慢性病中糖尿病视网膜病的静脉内抗VEGF治疗
Sourabh Sharma1, Pradeep Venkatesh2, Sanjay Kalra3,4
1Department of Nephrology, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, India. drsourabh05@gmail.com.
概括
糖尿病视网膜病变 (DR) 的静脉内抗血管内皮生长因子 (anti-VEGF) 治疗可能会影响慢性病患者的脏. 本研究提出了一个框架和诊断标准,用于管理抗VEGF相关性病 (AVAN).
科学领域:
- 眼科和科的眼科和科.
- 阴道鼻医学 阴道鼻医学
- 眼疗法的系统性影响
背景情况:
- 内抗血管内皮生长因子 (抗VEGF) 治疗是糖尿病视网膜病变 (DR) 的标准.
- 患有糖尿病和慢性病 (CKD) 的患者需要对抗VEGF治疗进行仔细的风险效益评估.
- 内抗VEGF的全身吸收可能会影响功能,特别是那些有先前存在病的人.
研究的目的:
- 提出一个基于证据的框架,以安全的抗VEGF治疗DR患者的CKD.
- 介绍和定义一种新的神经综合征:抗VEGF相关性病 (AVAN).
- 为AVAN提供诊断标准,严重程度分类和治疗建议.
主要方法:
- 对抗VEGF药物的系统吸收新出现的证据的审查.
- 开发一个临床框架来管理DR和CKD接受抗VEGF治疗的患者.
- 基于临床和病理发现的AVAN诊断标准和分类建议.
主要成果:
- 鉴定系统性抗VEGF吸收对CKD患者内皮的潜在负面影响.
- 介绍了作为一个独立的临床实体的抗VEGF相关性病 (AVAN) 的概念.
- 对AVAN的诊断,分级和管理进行结构化方法的概要.
结论:
- 在患有慢性病的DR患者中,抗VEGF治疗需要谨慎采取措施,因为可能会产生方面的副作用.
- 为AVAN提出的框架和诊断标准旨在指导临床医生管理这种新出现的综合征.
- 需要进一步的研究,以充分阐明AVAN的病理生理学和长期影响.
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