康柏西普玻璃体腔注射联合全视网膜光凝术治疗重度非增殖性糖尿病视网膜病变合并黄斑水肿的效果  

Effect of intravitreal injection of conbercept combined with panretinal photocoagulation in the treatment of severe non-proliferative diabetic retinopathy with macular edema

作　　者：岳金良 龙云 赵梦瑶[1] Yue Jinliang;Long Yun;Zhao Mengyao(Department of Ophthalmology,Zhoukou Central Hospital,Zhoukou 466000,China)

机构地区：[1]周口市中心医院眼科,周口466000

出　　处：《中国实用医刊》2024年第10期49-52,共4页Chinese Journal of Practical Medicine

摘　　要：目的分析康柏西普玻璃体腔注射联合全视网膜光凝术(PRP)治疗重度非增殖性糖尿病视网膜病变(NPDR)合并黄斑水肿的效果。方法队列研究。抽取2020年11月至2022年11月周口市中心医院收治的重度NPDR合并黄斑水肿患者76例, 按随机数字表法分为联合组与PRP组, 每组38例。PRP组予以PRP治疗, 联合组在PRP组治疗基础上联合康柏西普玻璃体腔注射治疗。对比两组最佳矫正视力(BCVA)、治疗效果、房水中基质细胞衍生因子-1(SDF-1)及血管内皮生长因子(VEGF)水平、黄斑中心凹厚度(CMT)、眼底微循环[红细胞变形指数(EDI)、血浆黏度(PV)]水平及并发症发生率。结果联合组总有效率(94.74%, 36/38)高于PRP组(78.95%, 30/38), P<0.05。治疗1、3、6个月后, 联合组BCVA高于PRP组(P<0.05);治疗1、3、6个月后, 联合组CMT低于PRP组(P<0.05);治疗后, 联合组房水中SDF-1、VEGF水平低于PRP组(P<0.05);治疗后, 联合组PV、EDI水平均低于PRP组(P均<0.05)。联合组并发症发生率(5.26%, 2/38)与PRP组(13.16%, 5/38)比较差异未见统计学意义(P>0.05)。结论康柏西普玻璃体腔注射联合PRP治疗重度NPDR合并黄斑水肿患者, 能够增强治疗效果, 提高视力水平, 降低房水中SDF-1、VEGF水平, 缓解黄斑水肿, 改善眼底微循环, 安全性良好。Objective To analyze the effect of intravitreal injection of conbercept combined with panretinal photocoagulation(PRP)in the treatment of severe non-proliferative diabetic retinopathy(NPDR)with macular edema.Methods Seventy-six patients with severe NPDR complicated by macular edema treated in Zhoukou Central Hospital from November 2020 to November 2022 were selected for the cohort study.And they were divided into a combination group and a PRP group according to random number table method,with 38 cases in each group.The PRP group was treated by PRP,and the combination group was treated by intravitreal injection of conbercept based on the treatment of the PRP group.The best corrected visual acuity(BCVA),treatment effect,levels of stromal cell-derived factor-1(SDF-1)and vascular endothelial growth factor(VEGF)in aqueous humor,central macular thickness(CMT),levels of fundus microcirculation assessed by erythrocyte deformability index(EDI)and plasma viscosity(PV),and complication rate were compared between the two groups.Results The total effective rate of the combination group(94.74%,36/38)was higher than that of the PRP group(78.95%,30/38),P<0.05.The BCVA in the combination group was higher than that in the PRP group 1,3 and 6 months after treatment(P<0.05).The CMT in the combination group was lower than that in the PRP group 1,3 and 6 months after treatment(P<0.05).The levels of SDF-1 and VEGF in aqueous humor in the combination group were lower than those in the PRP group after treatment(P<0.05).After treatment,the level of PV and EDI in the combination group were lower than those in the PRP group(all P<0.05).There was no significant difference in the incidence of complications between the combination group(5.26%,2/38)and the PRP group(13.16%,5/38),P>0.05.Conclusions In the treatment of severe NPDR patients with macular edema,intravitreal injection of conbercept combined with PRP can enhance the therapeutic effect,improve the visual acuity level,reduce the levels of SDF-1 and VEGF in aqueous humor,alleviate macula

关 键 词：黄斑水肿 康柏西普 全视网膜光凝术 非增殖性糖尿病视网膜病变 

分 类 号：R587.2[医药卫生—内分泌] R779.6[医药卫生—内科学]