3种不同方案治疗糖尿病性黄斑水肿疗效分析  

Effect Analysis of Three Different Methods in Treatment of Diabetic Macular Edema

作　　者：李相军[1] 王敬怡 李春燕[1] 张建东 黄海[1] 白丹[1] 石盛玲 冷瀛[1] LI Xiangjun;WANG Jingyi;LI Chunyan;ZHANG Jiandong;HUANG Hai;BAI Dan;SHI Shengling;LENG Ying(Affiliated Hospital of Beihua University,Jilin 132011,China;Changchun Purui Eye Hospital,Changchun 130021,China)

机构地区：[1]北华大学附属医院,吉林吉林132011 [2]长春市普瑞眼科医院,吉林长春130021

出　　处：《北华大学学报（自然科学版）》2024年第2期224-227,共4页Journal of Beihua University（Natural Science）

基　　金：吉林省教育厅科学技术研究项目(JJKH20220072KJ);吉林省科技发展计划项目(20200201495JC)。

摘　　要：目的探讨3种不同方案治疗糖尿病性黄斑水肿的临床疗效。方法选取经眼底检查、眼底血管造影、OCT检查确诊为糖尿病性黄斑水肿的患者120例120眼,将患者分为3组,A组(单纯注药组):25例25眼,采用康柏西普注射液0.5 mg/0.05 mL眼内注射,1次/月,连续注射3次后按需治疗;B组(激光组):25例25眼,患者采用全视网膜光凝(PRP)治疗,1个月内完成;C组(联合组):70例70眼,采用注药+光凝治疗,患者先行康柏西普注射液0.5 mg/0.05 mL眼内注射,1次/月,连续注射3次后按需治疗,期间完成PRP。治疗后1、3、6、12个月观察3个治疗组的黄斑中心凹视网膜厚度(CMT)、黄斑区中心凹脉络膜厚度(SFCT)、最佳矫正视力(BCVA),分析CMT、SFCT与视力变化之间的相关性。结果治疗后1、3、6、12个月,3组患者的黄斑中心视网膜厚度(CMT)、黄斑中心凹脉络膜厚度(SFCT)、最佳矫正视力(BCVA)均较治疗前有改善,单纯注药组及联合组疗效明显优于激光组(P<0.01),联合组疗效优于单纯注药组(P<0.01)。CMT与最佳矫正视力变化密切相关,CMT越下降,最佳矫正视力提高越明显。结论应用3种不同方法治疗糖尿病性黄斑水肿,结果显示,CMT、SFCT、BCVA联合组疗效最佳,其次是单纯注药组、激光组;脉络膜厚度、视网膜厚度与最佳矫正视力变化密切相关,脉络膜厚度及视网膜厚度越下降最佳矫正视力提高越明显。Objective To evaluate the clinical efficacy of 3 different regimens in the treatment of diabetic macular edema.Methods 120 patients(120 eyes)with diabetic macular edema confirmed by fundus exam-ination,fundus angiography and OCT examination were selected and divided into three groups.Group A(single injection group):25 cases,25 eyes were injected intraocularly with Conbercept injection 0.5 mg/0.05 mL,once a month,and then treated as needed after 3 consecutive injections.Group B(laser group):25 cases,25 eyes,patients received panretinal photocoagulation(PRP)treatment,completed within 1 month.Group C(combin-ation group):70 cases,70 eyes were treated with drug injection and photocoagulation.Patients were first injected with Conbercept injection 0.5 mg/0.05 mL intraocular once a month,and then received treatment as needed after 3 consecutive injections,during which PRP was completed.The macular central retinal thickness(CMT),macular foveal choroid thickness(SFCT),best corrected visual acuity(BCVA),and the correlation between CMT and SFCT and visual acuity were observed at 1,3,6 and 12 month after treatment.Results Macular central retinal thickness(CMT),macular foveal choroidal thickness(SFCT)and best corrected visual acuity(BCVA)in 1,3,6,12 month all improved after treatment in 3 groups,and the curative effect of single injection group and combination group was significantly better than that of laser group(P<0.01),the curative effect of combination group was better than that of simple injection group(P<0.01).CMT is closely related to the change of the best corrected visual acuity,and the better corrected visual acuity improved with the decrease of CMT.Conclusion Among the three different treatment methods for diabetic macular edema,CMT,SFCT and BCVA showed the best effect in combination group,followed by injection group and laser group.The choroidal thickness,retinal thickness is closely related to change of the best corrected visual acuity,the best corrected visual acuity improved significantly with decreasing choroi

关 键 词：糖尿病 糖尿病性黄斑水肿 疗效 

分 类 号：R774.5[医药卫生—眼科]