摘要
目的观察眼底激光联合抗血管内皮生长因子(vascular endothelial growth factor,VEGF)药物治疗糖尿病黄斑水肿的血清学指标、最佳矫正视力、黄斑厚度的影响。方法选择2017年9月至2019年8月,糖尿病黄斑水肿患者82例90只眼,随机分为两组,分别为(1)激光组患者41例44只眼,给予眼底激光光凝治疗,光斑直径50~100μm、功率90~120 mW、曝光时间0.15 s;(2)联合药物治疗组患者41例46只眼,在眼底激光光凝治疗的基础上给予抗VEGF药物治疗。比较两组患者治疗前和治疗后3个月患眼最佳视力、黄斑厚度的变化,并检测患者血清一氧化氮合酶(Nitric oxide synthase,NOS)、白介素-6(Interleukin-6,IL-6)及VEGF水平改变,进行疗效评估。同时记录治疗期间患眼眼内炎、结膜下出血等并发症发生情况。结果治疗前,两组患者最佳矫正视力、黄斑厚度和血清学指标(VEGF、IL-6、NOS)比较,差异无统计学意义(P>0.05)。治疗后3个月,两组患者最佳矫正视力及NOS水平明显高于治疗前;黄斑厚度、VEGF、IL-6低于治疗前(P<0.05)。治疗后3个月,联合药物治疗组最佳矫正视力、NOS水平高于激光组;黄斑厚度、VEGF、IL-6水平低于激光组,两组间比较差异具有统计学意义(P<0.05)。联合药物治疗组总有效率(93.5%)高于激光组(79.6%),差异具有统计学意义(P<0.05);两组患眼并发症比较,差异无统计学意义(P>0.05)。结论激光联合抗VEGF药物治疗糖尿病黄斑水肿可显著改善多项血清指标水平、提高视力、减轻黄斑水肿、提升整体疗效,其安全可靠。
Objective To observe the joint effect of fundus laser and anti-vascular endothelial growth factors(VEGF)on the serum indexes,best corrected visual acuity and macular thickness of patients with diabetic macular edema.Methods Totally 82 patients(90 eyes)with diabetic macular edema from Sep.2017 to Aug.2019 were selected and divided randomly into two groups:the laser group(41 cases,44 eyes)in which the patients were treated with fundus laser,(spot diameter 50~100μm,power:90~120 mW,and exposure time:0.15 s),and the drug combination group(41 cases,46 eyes),in which the patients were given anti-VEGF drugs in addition.The best visual acuity,macular thickness,serum nitric oxide synthase(NOS),interleukin-6(IL-6)and VEGF levels were measured before and 3 months after the treatment for both groups.The curative effect was evaluated and the complications such as endophthalmitis and subconjunctival hemorrhage were recorded.Results There was no significant difference in BCVA,macular thickness,VEGF,IL-6 and NOS between the two groups before the treatment(P>0.05).Three months later,the best corrected visual acuity and NOS levels of both groups were significantly higher than those before the treatment and the macular thickness,VEGF and IL-6 lower than those before the treatment(P<0.05).The best corrected visual acuity and NOS levels of the drug combination group were higher than those of the laser group,and the macular thickness,VEGF and IL-6 levels of the formor lower than those of the laser group(P<0.05).The total effective rate of the drug combination group was higher than that of the laser group,and the difference was statistically significant(P<0.05),Howere,there was no significant difference between the two groups in the occurrence of complications(P>0.05).Conclusions As to the treatment of diabetic macular edema,the combined application of laser with anti-VEGF drugs will significantly improve the level of serum indicators,improve visual acuity,reduce macular edema and improve the overall efficacy while being safe and reliable.
作者
吴宇博
继康康
晏维玲
WU Yu-bo;JI Kang-kang;YAN Wei-ling(Department of Ophthalmology,the First Affiliated Hospital of Anhui Medical University,Hefei 230022,China)
出处
《中国激光医学杂志》
CAS
2020年第6期324-329,共6页
Chinese Journal of Laser Medicine & Surgery
作者简介
吴宇博(1992~),男,住院医师,安徽合肥人,主要研究方向为白内障的临床诊疗。
