康柏西普联合黄斑区激光光凝治疗糖尿病性黄斑水肿的疗效观察  

Observation on the curative effect of conbercept combined with macular laser photocoagulation in the treatment of diabetes macular edema

作　　者：许丹[1] 张新[1] 李奕萍[1] XU Dan;ZHANG Xin;LI Yiping(Department of Ophthalmology,The Third People’s Hospital of Mianyang,Sichuan Mental Health Center,Mianyang Sichuan 621000,China)

机构地区：[1]四川省绵阳市第三人民医院(四川省精神卫生中心)眼科,四川绵阳621000

出　　处：《中国临床医生杂志》2022年第10期1163-1167,共5页Chinese Journal For Clinicians

摘　　要：目的探究康柏西普联合黄斑区激光光凝治疗糖尿病性黄斑水肿(diabetic macular edema,DME)的疗效及对视网膜血流密度和血管内皮生长因子(vascular endothelial growth factor,VEGF)、基质细胞衍生因子1(stromal cell derived factor 1,SDF-1)水平的影响。方法选取2020年1月至2021年12月四川省绵阳市第三人民医院收治320例的DME患者为研究对象,按随机数字表法分为对照组和观察组,每组160例。对照组行康柏西普玻璃体腔内注射治疗,观察组行康柏西普玻璃体内注射联合黄斑区激光光凝治疗。比较两组临床疗效,观察治疗前和治疗3、6个月时最佳矫正视力(best corrected visual acuity,BCVA)、黄斑中心厚度(central macular thickness,CMT)、视网膜血流密度[黄斑区视网膜浅层毛细血管丛(macular retinal shallow capillary plexus,SVC)、深层毛细血管丛(deep capillary plexus,DVC)及黄斑中心凹无血管区宽度范围300μm内(macular central concave non-vascular zone width within 300μm,FD-300)]及房水中VEGF、SDF-1水平。结果观察组临床总有效率(93.12%)明显高于对照组(82.62%),差异有显著性(P<0.05)。与对照组相比,观察组治疗6个月时的BCVA更优、CMT更低(P<0.05)。观察组治疗6个月时的SVC血流密度、DVC血流密度、FD-300血流密度均明显高于对照组(P<0.05)。观察组治疗6个月时房水中VEGF、SDF-1水平均明显低于对照组(P<0.05)。结论康柏西普联合黄斑区激光光凝治疗DME的疗效明显提高,可有效改善患者视力,促进黄斑解剖结构恢复,提高视网膜血流密度,降低VEGF、SDF-1水平。Objective To investigate the efficacy of conbercept combined with macular laser photocoagulation in the treatment of diabetic macular edema(DME)and its effects on retinal blood flow density,vascular endothelial growth factor(VEGF)and stromal cell derived factor 1(SDF-1)levels.Method 320 DME patients admitted to our hospital from January 2020 to December 2021 were selected as the research objects and randomly divided into the control group and the observation group according to the random number table method,with 160 cases in each group.The control group was treated with intravitreal injection of Compacept,and the observation group was treated with intravitreal injection of Compacept combined with macular laser photocoagulation.The clinical efficacy of the two groups was compared.The best corrected visual acuity(BCVA),central macular thickness(CMT),retinal blood flow density[macular retinal shallow capillary plexus(SVC),deep capillary plexus(DVC)and macular central concave non-vascular zone width within 300μm(FD-300)]and the levels of VEGF and SDF-1 in aqueous humor were compared before treatment and 3 and 6 months after treatment.Result The total effective rate of the observation group was significantly higher than that of the control group(93.12%vs 82.62%,P<0.05).Compared with the control group,the observation group had better BCVA and lower CMT at 6 months of treatment(P<0.05).The SVC blood flow density,DVC blood flow density and FD-300 blood flow density in the observation group after 6 months of treatment were significantly higher than those in the control group(P<0.05).After 6 months of treatment,the levels of VEGF and SDF-1 in aqueous humor in the observation group were significantly lower than those in the control group(P<0.05).Conclusion The curative effect of Compacept combined with macular laser photocoagulation in the treatment of DME was significantly improved,which could effectively improve the visual acuity of patients,promote the recovery of macular anatomical structure,improve retinal blood flow

关 键 词：康柏西普 激光光凝 糖尿病性黄斑水肿 视网膜血流密度 血管内皮生长因子 基质细胞衍生因子1 

分 类 号：R774[医药卫生—眼科]