复方樟柳碱联合视网膜激光光凝治疗重度非增殖性糖尿病视网膜病变  

Compound anisodine combined with retinal laser photocoagulation for the treatment of severe non-proliferative diabetic retinopathy

作　　者：安鑫 焦剑 魏文斌[2] 张茉莉 An Xin;Jiao Jian;Wei Wenbin;Zhang Moli(Department of Ophthalmology,Daxing Teaching Hospital Affiliated to Capital Medical University,Beijing 102600,China;Beijing Tongren Hospital,Capital Medical University,Beijing Tongren Eye Center,Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment,Beijing Key Laboratory of Ophthalmology&Visual Sciences,Medical Artificial Intelligence Research and Verification Key Laboratory of the Ministry of Industry and Information Technology,Beijing 100730,China)

机构地区：[1]首都医科大学大兴教学医院眼科,北京市102600 [2]首都医科大学附属北京同仁医院、北京同仁眼科中心、眼内肿瘤诊治研究北京市重点实验室、北京市眼科学与视觉科学重点实验室医学人工智能研究与验证工信部重点实验室,北京市102600

出　　处：《国际眼科杂志》2024年第5期790-794,共5页International Eye Science

基　　金：国家自然科学基金(No.82220108017,82141128);首都卫生发展科研专项(No.首发2020-1-2052);北京市科委科技计划项目(No.Z201100005520045,Z181100001818003);首都医科大学大兴教学医院院内课题(No.4202320476)。

摘　　要：目的:观察复方樟柳碱联合视网膜激光光凝治疗重度非增殖性糖尿病视网膜病变(NPDR)的疗效。方法:采用回顾性研究方法,选取2023-05/07于北京同仁医院和首都医科大学大兴教学医院就诊的重度NPDR患者120眼,按照治疗方法不同将纳入患者分为两组,观察组为全视网膜激光光凝联合应用复方樟柳碱注射液治疗60眼,对照组为全视网膜激光光凝治疗60眼。应用光学相干断层扫描血流成像(OCTA)和光学相干断层扫描方法(OCT)对眼底视网膜结构及血流进行定量分析。比较两组治疗前,治疗后1 d, 1、2 mo的最佳矫正视力(BCVA)、浅层毛细血管丛血流密度(SVD)、深层毛细血管丛血流密度(DVD)、脉络膜血流密度、黄斑中心凹视网膜厚度(CMT)。结果:治疗后2 mo观察组患者自觉视力改善率及BCVA明显优于对照组,黄斑水肿发生率低于对照组(P<0.05)。两组患者治疗后1、2 mo BCVA较治疗前均增高(P<0.05)。治疗后1 d, 1、2 mo观察组SVD优于对照组(均P<0.05)。治疗后1 d观察组DVD及脉络膜血流密度优于对照组(均P<0.05)。治疗后1 d观察组CMT小于对照组(P<0.05)。结论:复方樟柳碱可以有效改善全视网膜激光术后的眼底微循环情况,减少视网膜光凝导致黄斑水肿的发生,从而提高患者视功能。AIM:To investigate the clinical efficacy of the compound anisodine combined with retinal laser photocoagulation in the treatment of severe non-proliferative diabetic retinopathy(NPDR).METHODS:According to the retrospective study,totally 120 eyes of patients with severe NPDR who admitted to Daxing Teaching Hospital Affiliated to Capital Medical University from May 2023 to July 2023 were selected.The patients were divided into the observation group and the control group according to treatment methods,with 60 eyes in each group.The observation group was treated with panretinal photocoagulation combined with the compound anisodine injection.The control group was only treated with panretinal photocoagulation.The optical coherence tomography angiography(OCTA)and optical coherence tomography(OCT)were used to quantitatively analyze the fundus retinal structure and blood flow.Furthermore,the best corrected visual acuity(BCVA),superficial vascular density(SVD),deep vascular density(DVD),choroidal blood flow density and central macular foveal retinal thickness(CMT)were compared before treatment and at 1 d,1 and 2 mo after treatment.RESULTS:At 2 mo postoperatively,the rate of visual improvement and the BCVA in the observation group of patients were significantly better than those of the control group,and the incidence of macular edema in the observation group was significantly lower than the control group(P<0.05).The BCVA at 1 and 2 mo after treatment were significantly higher than those before treatment in both groups(P<0.05).The SVD in the observation group was better than the control group at 1 d,1 and 2 mo after treatment(all P<0.05).The DVD and choroidal flow density in the observation group were better than those of the control group at 1 d after treatment(all P<0.05).The CMT of the observation group was smaller than that of the control group at 1 d after treatment(P<0.05).CONCLUSION:Compound anisodine can effectively improve the fundus microcirculation after panretinal photocoagulation and reduce the incidence of macu

关 键 词：复方樟柳碱 重度非增殖性糖尿病视网膜病变 光学相干断层扫描血流成像 黄斑水肿 全视网膜激光光凝 

分 类 号：R587.2[医药卫生—内分泌] R774.1[医药卫生—内科学]