阿柏西普玻璃体内注射联合激光光凝治疗糖尿病性黄斑水肿的临床疗效  

Effects of Intravitreal Injection of Aflibercept Combined with Laser Photocoagu 1 at ion on Visual Function and Prognosis of Patients with Diabetic Macular Edema

作　　者：刘振通 秦虹[1] 田楠楠[1] LIU Zhen-tong;QIN Hong;TIAN Nan-nan(Eye Hospital,China Academy of Chinese Medical Sciences,Beijing 100040 China)

机构地区：[1]中国中医科学院眼科医院,北京100040

出　　处：《医学临床研究》2021年第9期1292-1295,共4页Journal of Clinical Research

摘　　要：【目的】探讨阿柏西普玻璃体内注射联合激光光凝治疗糖尿病性黄斑水肿(DME)的临床疗效。【方法】选取2018年6-12月在本院诊治的86例DME患者为研究对象,采用随机数表法分为对照组及观察组,每组43例。对照组给予雷珠单抗玻璃体内注射联合激光光凝治疗,观察组给于阿柏西普玻璃体内注射联合激光光凝治疗。比较两组患者临床疗效、不良事件发生率及治疗前、治疗4周、治疗12周后黄斑中心凹厚度(CMT),眼压和不同基线视力者视力[最住矫正视力(BCVA)],并评估治疗前及治疗24周后视功能损害眼病患者生活质量量表(SQOL-DVI)评分并比较。【结果】观察组总有效率为95.35%(41/43),显著高于对照组的79.07%(34/43),其差异有统计学意义(χ^(2)=5.11,P=0.02)。观察组患者不良事件发生率为6.98%(3/43),与对照组的11.63%(5/43)比较,差异无统计学意义(χ^(2)=0.55,P=0.46)。两组患者治疗前后CMT及基线视力较好者、基线较差者BCVA比较,均为治疗前>治疗4周〉治疗12周(P<0.05);且治疗4周、12周时,观察组患者CMT,基线较差者BCVA均低于对照组(P<0.05),但两组患者基线视力较好者BCVA比较,差异无统计学意义(P>0.05);两组患者治疗前后冬时间点组间及组内眼压比较,差异均无统计学意义(P>0.05)。治疗24周后,两组临床症状和视功能、身体机能、社会活动及精神心理维度SQOL-DVI评分均较治疗前升高,且观察组高于对照组,其差异均有统计学意义(P<0.05)。【结论】阿柏西普玻璃体内注射联合激光光凝治疗DME对基线视力较差患者更具有优势,可有效改善患者视觉功能,并提高患者生活质量,安全性较高,值得临床推广应用。【Objective】To explore the effects of intravitreal injection of aflibercept combined with laser photocoagulation on visual function and prognosis of patients with diabetic macular edema(DME).【Methods】From June 2018 to December 2018,86 patients with DME in our hospital were selected as the research objects and were divided into the control group and the observation group according to the random number table method,with 43 cases in each group.Control group was given intravitreal injection of ranibizumab while observation group was given intravitreal injection of aflibercept;and all patients in the two groups received laser photocoagulation after 1〜2 weeks of intravitreal injection.The clinical efficacy and occurrence of adverse events were recorded in the two groups,and the central macular foveal thickness(CMT),intraocular pressure and visual acuity of different baseline vision[best corrected visual acuity(BCVA)]were compared between the two groups before treatment and after 4 weeks and 12 weeks of treatment.The quality of life[quality of life scale for patients with visual functional lesions(SQOL-DVI)]was evaluated before treatment and after 24 weeks of treatment.【Results】The clinical efficacy in observation group was significantly higher than that in control group(P<0.05).There was no significant difference in the occurrence of adverse events between the two groups(P>0.05).The comparison of CMT before and after treatment in the two groups showed CMT before treatment>at 4 weeks of treatment>at 12 weeks of treatment(P<0.05).And at 4 and 12 weeks of treatment,the CMT in observation group was lower than that in control group(P<0.05).There was no statistically significant difference in the intraocular pressure between the two groups and within the groups at different time points before and after treatment(P>0.05).The comparison of BCVA before and after treatment in the two groups with better baseline vision showed BCVA before treatment>at 4 weeks of treatment>at 12 weeks of treatment(P<0.05).But there was

关 键 词：糖尿病/并发症 黄斑水肿/病因学 黄斑水肿/治疗 玻璃体内注射 激光凝固术 

分 类 号：R587.26[医药卫生—内分泌]