周边视网膜光凝治疗中度非增殖期糖尿病视网膜病变的临床疗效观察  

Efficacy of laser photocoagulation in the treatment ofmoderate non-proliferative diabetic retinopathy

作　　者：张竖[1] 姜士军[1] 蒋燕玲[1] 朱彦霞[1] 徐强[1] 程艳[1] 

机构地区：[1]江苏省连云港市第二人民医院眼科,222000

出　　处：《中华眼科医学杂志（电子版）》2015年第1期27-31,共5页Chinese Journal of Ophthalmologic Medicine(Electronic Edition)

摘　　要：目的探讨中度非增殖期糖尿病视网膜病变（NPDR）行周边视网膜光凝的必要性。方法收集2008年10月至2011年10月连云港市第二人民医院眼科收治的106例（106只眼）血糖控制欠佳且眼底处于中度NPDR患者的临床资料。按照治疗方法将65例（65只眼）行视网膜光凝治疗的患者作为光凝组,将41例（41只眼）未行视网膜光凝治疗的患者作为非光凝组。术后6~36个月对所有患者行荧光素眼底血管造影（FFA）检查,观察两组患者的视力情况、眼底情况及中心视野情况。两组患者的视力情况以例数和百分比的形式表示,并采用Kruskal-Wallis H秩和检验的方法进行比较;两组患者的视网膜病变情况以例数和百分比的形式表示,并采用χ2检验的方法进行比较;激光治疗前及治疗6个月光凝组患者视野平均敏感度（MS）以均数±标准差（x珋±s）的形式表示,并采用t检验的方法进行比较。结果治疗后18个月,光凝组患者视力好转者16例（16只眼）,占24.61%;视力稳定者36例（36只眼）,占55.38%;视力下降者13例（13只眼）,占20.00%。非光凝组患者视力稳定者33例（33只眼）,占80.48%;视力下降者8例（8只眼）,占19.52%。两组比较,差异有统计学意义（Hc=14.93,P〈0.05）。治疗后36个月,光凝组患者视力好转者10例（10只眼）,占15.38%;视力稳定者38例（38只眼）,占58.46%;视力下降者17例（17只眼）,占26.16%。非光凝组患者视力稳定者21例（21只眼）,占51.22%;视力下降者20例（20只眼）,占48.78%。两组比较,差异有统计学意义（Hc=10.92,P〈0.05）。治疗后18个月,光凝组患者视网膜病变稳定者59例（59只眼）,占90.77%;视网膜病变进展者6例（6只眼）,占9.23%。非光凝组患者视网膜病变稳定者31例（31只眼）,占75.61%;视网膜病变进展者10例（10只眼）,占24.39%。两组比较,差异有统计学意义（χ2=4.51,P〈0.05）。治疗36个月,光凝组患者视�Objective To evaluate the efficacy of laser retinal photocoagulation in the treatment of early moderate non-proliferative diabetic retinopathy（ NPDR）. Methods A total of 106 NPDR patients（ 106 eyes） with inadequately controlled type 2 diabetes mellitus（ T2DM） who were seeking care in the Department of Ophthalmology,Lianyungang Second People＇ s Hospital in Dalian between October,2008 and October,2010 were recruited. Of them,65 were treated with laser retinal photocoagulation and the remaining41 served as non-photocoagulation treatment control subjects. All subjects were followed up for 6-36 months,during which fundus fluorescein angiography was performed and changes in visual acuity,central visual field sensitivity and ocular fundus features were assessed. Results At 18 months after treatment,there was a significant difference in visual acuity between two groups（ Hc = 14. 93,P〈0. 05）; while visual acuity was improved,stable and decreased in 16（ 24. 61%）,36（ 55. 38%） and 13（ 20. 00%） cases,respectively,in the photocoagulation group,it remained stable in 33（ 80. 48%） cases and was decreased in 8（ 19. 52%）cases in the control group. At 36 months after treatment,the difference in visual acuity between two groups remained significant（ Hc = 10. 92,P〈0. 05）; while visual acuity was improved,stable and decreased in 10（ 15. 38%）,38（ 58. 46%） and 17（ 26. 16%） cases,respectively,in the photocoagulation group,it remained stable in 21（ 51. 22%） cases and was decreased in 20（ 48. 78%） cases in the control group. The proportion of patients experiencing NPDR progression was significantly lower in the photocoagulation treatment group than in the control group at both 18 months（ χ2= 4. 51,P〈0. 05） and months（ χ2= 12. 12,P〈0. 05）. The mean sensitivity of central visual field was 23. 59 ± 0. 48 d B and 23. 42 ± 0. 50 d B before and after retinal photocoagulation respectively in the photocoagulation group（ P = 0. 055）. Conclusions Laser retinal photo

关 键 词：非增殖期糖尿病视网膜病变 糖尿病 激光治疗 

分 类 号：R779.63[医药卫生—眼科]